Vol 75, No 5 (1994)

Unsolved problems of specialized prophylactic medical examination of victims of emergency, occupational and medical exposures

Mikhailov M.K.


Frequent natural disasters, man-made disasters and social upheavals significantly affect the quality of life and the ecological space in which we live. In the changed conditions, the shortcomings of health care and the higher medical school became obvious, which based their priorities on the concept of organopathological medicine.

Kazan medical journal. 1994;75(5):337-338
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Социальная гигиена

Problems of prophylactic medical examination and rehabilitation of citizens of Tatarstan Republik after irradiation in the elimination of radiation accidents

Karatai S.S.


The radiation accidents in the South Urals and Chernobly present specific problems for public health of Tatarstan Rebublik. Among these is primarily the necessity to create the special-purpose prophylactic medical examination of the eliminators of radiation accidents. The conception to provide emergency medical service in radiation accidents in Tatarstan Republik is considered in connection with the initiation of technogenic contamination by radium-226 at a number of enterprises. The emphasis is on the suggestion to provide extrahospital medical service to the victims of radiation, chemical, transport accidents with regard to the possibilities of the Republik Center of emergency medical service of the Ministry of Publik Health of Tatarstan Republik.

Kazan medical journal. 1994;75(5):338-342
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New conception of radiation protection of population

Ivanov E.V.


The aims, tasks and methods of radiation safety provision in Russia on the basis of content and requirements of new conception of radiation, medical and social protection and rehabilitation of the Russian Federation population after irradiation are presented. The conception is confirmed by the National Radiation Protection Commission in the ministry of Public Health of the Russian Federation.

Kazan medical journal. 1994;75(5):343-345
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Biological effect of small doses of ionizing radiation and problems of radiation safety rate fixing

Ramzaev P.V.


Medico-biological consequences of radiation accidents are considered in the context of linear relationship on the model of «dose-effect» and probabilistic stochastic changes without a threshold. If the first group of changes occurs proportionally to the individual irradiation dose, so the second group is reliably tracked by the calculation of the collective irradiation dose. The damage caused to public health by the Chernobyl accident is approximately 20 times smaller than by nuclear explosions in Hirosima and Nagasaki. The principles to develop the new normative documents on radiation safety are presented.

Kazan medical journal. 1994;75(5):345-347
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Radiation and hygienic situation in Tatarstan Republik

Morozov V.G.


Caesium-137 of a global origin is found in some regions of Kazan, near the Volga and near the Kama. The greatest density of distribution does not exceed the level of 18,5 kBq/m2. The collective dose of irradiation from global precipitation equals 48 persons/Sv. The content of caesium-137, strontium-90 in milk, meat, potatoes and bread is about 1000 times smaller than the prescribed allowable levels for the present. Technogenic contamination by radium-226 is found in some areas of industrial territories in Kazan, Mendeleevsk, Chistopol, Almetyevsk and Naberezhnye Chelny. Medical radiologic investigations have a pronounced effect on the collective dose of irradiation.

Kazan medical journal. 1994;75(5):348-351
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Radiation and ecologic situation in Tatarstan Republik

Kopeikin V.A., Fedotov V.M., Saifutdinov R.G., Khalitov R.M.


The radiation situation in Tatarstan Republik is estimated as normal. The emphasis is placed upon the possibility of radioactive contamination of subsoil waters in the south of the republik after spills of liquid radioactive wastes by the Dmitrovgrad scientific institute of nuclear reactors (the Ulyanovsk region). The reconstruction of the existing burial place of radioactive wastes and the creation of inter-district points for storing of collected radioactive subsil are necesseary.

Kazan medical journal. 1994;75(5):351-354
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Analysis of professional irradion in Tatarstan Republik

Zaripova L.D.


The essential contributions to the populational dose of Tatarstan Republik population caused by artificial sources of ionizing radiation are considered. The merits of the centralizing regional individual radiation control using thermoluminiscence dosimeters for the personnel of A category are shown. The results of individual dosimetric control from 1991 in subdivisions of medical institutions and industrial enterprises are analysed. The conclusions regarding the possible ways of the collective dose decrease for Tatarstan Republik population are made.

Kazan medical journal. 1994;75(5):354-356
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Tactical and technical characteristic of individual protection means using in radiation danger

Zamirova L.B., Sharnin G.P., Zhilyaev G.G., Zaripov I.N., Kapustina N.M.


The protective material against radiation (beta-, gamma- and roentgen) obtained by means of mechanical filling of porous polimeric materials with water metal suspensions is developed. The filler content in the material and consequently, leaden equivalent quantity vary in the wide range (between 0,1 and 0,9 mm Pb) and are regulated in the process of material production. A number of protective products for the use in extreme radiation condiations, in regulated repairs at industrial works, as well as roentgen-protective means for medical scientific and industrial institutions and works is developed.

Kazan medical journal. 1994;75(5):357-360
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Experience of the prophylactic medical examination of agricultural animals and sanitary examination of foodstuffs at the region suffering from the accident at the Chernobyl Nuclear Power Station

Kirshin V.A.


The nature of thyroid changes determined pathohistologically in agricultural animals allowed to be oriented in the contamination density of the region by iod-131 providing support by aerogammaspectrometry data. Nearly complete thyroid aplasia of cattle corresponding to the dose load on it in 300—500 Sv occured at the regions where the contamination density by iod-131 reached 2,4 MBq/m2.

Kazan medical journal. 1994;75(5):361-362
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Assessment of biological and calculation dosimetry methods

Badyugin I.S.


The formula is proposed for the calculation of contamination density by gamma-active caesium isotopes by radiation background and vice versa: 1 Ci/km2= (7,55±0,44) µR/h. This equation practically corresponds to our calculations by Zhuravlev reference: 1 Ci/km2=7,7 µR/h. The hematologic nomograms allow a physician to be quickly oriented in the diagnosis and medical assortment of acute damages of persons by uniform gamma-irradiation in the range of doses between 1 and 10 Gy. Adapted to the Chernobyl accident conditions the calculation method of the determination of small doses of chronic irradiation by the Blare mathematical model is simple and convenient. By its results it is close to the probabilistic model of chronic irradiation used by the international group «Chernobyl project».

Kazan medical journal. 1994;75(5):362-367
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Theoretical and clinical medicine

Medical consequences of the accident at the Chernobyl Nuclear Power Station

Galiev A.S., Spassky B.B., Khalitov R.I.


The gravity extent of the effect of radiation factors of the accident on population is analysed. The unfavourable demographic situation on the territories contaminated by radionucleoids, death rate and sickness rate of population are practically identical with the corresponding indicators in these regions which are not contaminated by the accident discharge products. The psychical deadaptation of 50% of the population as a result of radiophobia belongs to the medical consequences of the accident. The establishing psychotherapeutic service is bound to protect from this factor offect. Particular emphasis is placed upon the rate increase of endocrinie and oncologic diseases with short latent period undoubtedly associated with the rise of the collective irradiation dose.

Kazan medical journal. 1994;75(5):367-371
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Assessment of the efficacy of radioprotective compounds in radiation therapy of larynx carcinoma

Gileva T.G., Lukin A.V., Nyushkin A.A., Agachev A.R., Studentsova I.A., Vizel A.O.


The intensity of acute radiation on microdensitometric complex in 123 with malignant tumors of the larynx is investigated. The thickness of the larynx air column in the range of the dose from 0 to 40 Gy is studied in patients of 3 groups as required by the applied radioprotector (15% solution of dimephosphone, sea-buckthorn oil, Evdoshchenko’s solution). The data obtained allow to establish the manifestation of acute radiation reaction as required by the applied radioprotector and to estimate the efficacy of the last-mentioned one using the automatic microdensitometry.

Kazan medical journal. 1994;75(5):374-375
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Diseases of blood and hemopoietic organs in persons involved in the accident elimination at the Chernobly Nuclear Power Station

Tukov A.R., Dragoeva L.G.


The sickness rate of blood and hemopoietic organs of eliminators of the accident at the Chernobyl nuclear station is estimated. The necessary information is obtained from the data base of the Branch record. The general sickness rate of this type of diseases is 2,86±0,3 to 1000 observed persons. In women anemias are 6 times more frequent. The malignant tumors of hemopoietic and lymphatic tissue are revealed in 6 patients. The dependence on the irradiation dose is not established.

Kazan medical journal. 1994;75(5):371-373
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Roentgenodiagnosis of radiation changes of the small intestine

Abdulkhakova D.A.


Clinico-roentgenologic changes of the small intestine in 87 women after radiotherapy performed in case of cervical carcinoma of I—III stages are studied. The changes of the small intestine in early and late terms after radiotherapy in the form of dyskinesia, pathologic segmentation, flocculation, more rarely fragmentation of barium suspension column, in some cases, mucous membrane folds edema are revealed. The ileum located in radiation zone is principally damaged. The changes are more pronounced in patients with fixation of intestinal loops by postoperative commissures and suffering from enteritis before radiotherapy. The inadequacy of complaints of patients to the manifestation extent of the small intestine changes revealed by roentgenodiagnosis is characteristic.

Kazan medical journal. 1994;75(5):377-379
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Essential similarity and distinction of radiation injuries and other types of extreme pathology

Badyugin I.S., Sabitova A.I.


The agressive factor type, its dose, geometry and effect intensity determine the content change nature of adenylic acids, hormones and electrolytes in blood and tissue.

Kazan medical journal. 1994;75(5):375-377
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Short articles

A case of intermittent hydrarthrosis in a 9-year-old girl

Pigalov A.P., Kulakova G.A., Volgina S.Y., Yakubova S.N., Solovyova N.A.


Intermittent hydrarthrosis is a disease characterized by inflammatory changes in the joints. The etiology of this ailment is unknown, however, a relationship with an allergic condition and endocrine disorders is noted. The clinical picture is characterized by a sudden onset. More often, the knee joints are involved in the pathological process, less often the ankle, hip. The joints of the hands are extremely rarely affected. In the absence of violations of the general condition against the background of a normal temperature, pain and swelling of one, possibly two joints suddenly appear. The joint increases in volume due to the accumulation of exudate. Periarticular tissues change slightly. The function of the joint suffers little. The disease is cyclical. In connection with the rare spread of intermittent hydrarthrosis, we present our own observation of such a patient.

Kazan medical journal. 1994;75(5):380-381
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Experience in reflexology of vertebral artery syndrome

Batyasov Y.I.


We studied the effectiveness of puncture reflexology (PR) in vertebral artery syndrome (SPA). We observed 61 patients with SPA at the age from 25 to 55 years (men — 24, women — 37). Previously, patients underwent outpatient and inpatient treatment in different years. In 23 patients, a form of compression-irritative SPA was revealed, in 38 patients - a reflex angiospastic syndrome. The symptomatology of SPA consisted of paroxysmal headaches, more often of the hemicranic type, cochleo-vestibular and visual disturbances, varying degrees of autonomic disorders and general neurotic syndrome. Radiographs of the cervical spine showed signs of degenerative-dystrophic changes, Kovacs subluxation, and in 2 cases of Chimerly's anomaly. Signs of hemodynamic disturbances of varying severity in the vertebrobasilar basin (changes in vascular tone, decreased blood flow) were observed on RZH in most patients. Changes in hemodynamics in most cases dominated on the side of pathology.

Kazan medical journal. 1994;75(5):381-381
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The role of pre-radiation topometric preparation of patients with malignant tumors of the oral cavity and oropharyngs in the prevention of radiation injuries

Gilev A.V., Volodin G.I., Mukhametshina F.F.


Precision clinical topometry is the most important attribute of pre-radiation preparation of patients. Its underestimation and implementation of radiation therapy on the basis of schematic planning, according to various authors, can cause the development of radiation injuries from 6-10% to 61.2% in patients with malignant tumors of the oral cavity and oropharyngeal region. This is due to the sharp gradient of the absorbed radiation dose arising from the inhomogeneity of the irradiated volume. The adequacy of the performed topometric studies is in direct proportion to the radiation damage.

Kazan medical journal. 1994;75(5):381-382
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Some indicators of the health status of participants in the liquidation of the accident at the Chernobyl Nuclear Power Plant

Potapova L.I., Rechanik P.G., Lando E.B.


Under dispensary supervision in the polyclinic of the city clinical hospital No. 12 there are 27 people who participated in the liquidation of the consequences of the Chernobyl accident. In 1993, a comprehensive medical examination of this contingent was carried out with the participation of occupational pathologists of the Republican Center for Occupational Pathology. Each case was considered individually, taking into account the state of health examined before exposure to radiation, data of the clinical picture and paraclinical research methods, specialist consultations; the final conclusion was formulated after a panel discussion. The participation of specialist doctors from the Republican Center for Occupational Pathology and the Ministry of Health of the Republic of Tatarstan was of an advisory nature, since regional interdepartmental expert councils created in Russia have the authority to resolve expert issues to establish a connection between existing deviations in the health status of persons with radiation exposure.

Kazan medical journal. 1994;75(5):382-382
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Prevention of radiation damage

Gilev A.V., Volodina G.I.


The development and implementation of precision methods for pre-radiation topodosimetric preparation has significantly reduced the frequency of radiation injuries. The use of the VDF and NSD factors made adjustments to the planning of bioequivalent radiation regimes. Despite this, radiation complications remain a frequent limiting factor in radiation therapy. Recent studies have shown that the development and formation of radiation damage seems to be a complex and diverse process, not all aspects of which have been sufficiently studied. In the overwhelming number of patients who have undergone radiation therapy, there is a decrease in immunity parameters [12]. In the development of radiation injuries, the infection of the radiation zone [17], the prevalence of the malignant process [4], and regional circulatory disorders [6] are of direct importance. The conditions that predispose to the occurrence of radiation damage are trauma and inflammation. The frequency of radiation damage increases with the use of various types of chemotherapy, especially in combination with radiation therapy and hyperthermia [10]. The listed factors, which determine the development of distant radiation damage, create a prerequisite for the development of measures that protect the healthy tissues surrounding the tumor [8].

Kazan medical journal. 1994;75(5):382-383
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To the question of the reltogenicity and immunogenic activity of staphylococcal toxoid in the subcutaneous intranasal method of donor immunization

Grigoriev V.E., Khisamutdinov A.G., Akatov A.K., Minakova L.V., Ulanova A.A., Bychenko V.D., Kamalov F.Z., Sidoruk E.A., Budnikova T.A., Markova S.A., Ferofontova S.L., Uronova A.V., Yurchenko P.I., Mindubaeva R.A., Ismagilova Z.M.


The ubiquitous spread of staphylococcal diseases among the population, as well as the lack of reliable means of protection and fight against them, make the issues of obtaining immunological preparations very urgent [1, 3].

Kazan medical journal. 1994;75(5):384-385
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Leading markers of clinical strains of Staphylococcus aureus circulating in obstetric institutions

Musina L.T., Gladkova K.K., Semina N.A.


Hospital-acquired infections (nosocomial infections) are a serious public health problem. According to V.T. Sokolovsky [6], annually they are registered in more than 5 million people, 200 thousand of whom die, and the economic damage is estimated at more than 500 million rubles. Obstetric and surgical institutions are "hospitals at risk" of nosocomial infections. On discharge from the maternity hospital, hospital strains of S. aureus are found in 60% of women in labor and 60–97% of newborns [2, 5]. In the structure of nosocomial infections, mastitis, thrombophlebitis, pyelocystitis prevail in mothers, and pyoderma and abscesses in children. In 81% of newborns and 89% of postpartum women, the causative agent is Staphylococcus aureus [3, 7].

Kazan medical journal. 1994;75(5):385-389
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Was there Chernobyl? (Notes on two medical concepts)

Vinokurov Y.B., Kopeikin V.A.


Overcoming social skepticism about the future of nuclear power and other highly efficient industries using fissile materials is, in our opinion, a matter of time, because in the near foreseeable future there is no other technically and economically feasible alternative to nuclear power due to the imminent fuel and energy crisis. However, it is bewildering the efforts of apologists for nuclear energy to minimize the degree of harmful radiation effects on the human body and on entire groups of people (NPP personnel, participants in the liquidation of the consequences of the Chernobyl accident, the population evacuated from the affected areas and the population of the regions that found themselves in the path of the radioactive cloud after the accident on ChNPP). Many studies, numerous publications of specialists in various fields, from nuclear physicists to physicians and biologists, have been devoted to the fulfillment of this very dubious task. These publications are systematized, carefully selected and published in special brochures, collections and whole books, in which there are no skeptical statements and research results of those specialists who adhere to a slightly different point of view or strongly reject the concept of "35 rem in a lifetime". Their opinion can be found mainly only with a careful study of the collections of reports at highly specialized thematic conferences, meetings, seminars, and even then mainly in the biomedical direction. But all their persistent calls to reconsider the concept of radiation, affecting people in a dose exceeding 35 rem per life, are met with fierce hostility, declared incompetent, populist or politically opportunistic, or even simply anti-scientific.

Kazan medical journal. 1994;75(5):390-394
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Joachim Romanovich Petrov (1893-1970)


On December 23-24, 1993, a scientific conference was held at the St. Petersburg Military Medical Academy (VMedA): "Actual problems of the pathophysiology of extreme conditions", dedicated to the 100th anniversary of the birth of Academician of the USSR Academy of Medical Sciences, Major General of Medical Service I.R. Petrov, Head of the Department of Pathological Physiology of the Medical Academy of Medical Sciences (1939-1963), Professor-Consultant of the Military Medical Academy (1963-1968), Chairman of the All-Union Society of Pathophysiologists (1960-1968), Honorary Chairman of this Society (1968-1970).

Kazan medical journal. 1994;75(5):395-396
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I republican scientific and practical conference dedicated to the medical and biological consequences of radiation accidents (Kazan, November 19, 1933)

Mikhailov M.K., Badyugin I.S.


The conference was attended by scientists from Kazan, Moscow and St. Petersburg, faculty and cadets of the Kazan Institute for Advanced Training of Physicians, Hematology, and hygienists-radiologists of cities and regions of the Republic of Tatarstan.

Kazan medical journal. 1994;75(5):397-397
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Scientific session of the Cardiological Scientific Center of the Russian Academy of Medical Sciences "Emergencies in Cardiology" (Moscow, January 20-21, 1994)

Arleevsky I.P., Safin I.N., Khasanov N.R.


Various aspects of the problem were discussed at the plenary and breakout sessions, as well as at the round table. Prof. M. Ya. Ruda (Moscow) in his report “Modern approaches to the treatment of acute myocardial infarction” noted that restoration of coronary blood flow is the key to successful treatment of the disease. Pointing out that myocardial necrosis begins 30 minutes after the occlusion of the coronary artery, after 2 hours 50% of the affected area "dies", and after 4 hours - all 100%, he stressed that from these positions, after 4 hours from the onset of the disease, thrombolytic therapy already ineffective. Therefore, it should be started at the prehospital stage. The most widely used tissue plasminogen activator and, especially, streptase (ST), with the use of which less often develop retrombosis and cerebral strokes. In addition, the CT is cheaper. In the prevention of retrombosis, aspirin, heparin can be useful (5000 units intravenously, then infusion of 1000 units per hour for 2 days under the control of blood clotting time). Prof. M. Ya. Ruda also said that at present, the administration of magnesium salts is widely used abroad in the acute period of myocardial infarction, which significantly reduces mortality. Perhaps, he added, "they will soon start with magnesium salts."

Kazan medical journal. 1994;75(5):397-398
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Professor Leopold Matveevich Rachlin


On April 11, 1994, at the 97th year of his life, a prominent therapist, scientist, teacher, public figure and Honored Scientist of the Russian Federation and the Republic of Tatarstan, Professor Leopold Matveyevich Rakhlin, died.

Kazan medical journal. 1994;75(5):399-399
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Новые методы и инструменты

Metrology of acute radiation reaction in patients with laryngeal cancer

Gileva T.G., Lukin A.V., Nyushkin A.A., Agachev A.R.


Acute radiation reactions in patients with malignant neoplasms of the larynx are a constant factor accompanying radiation therapy. The intensity and speed of their manifestation are ambiguous and depend on the stage of the malignant process.

Kazan medical journal. 1994;75(5):389-389
pages 389-389 views

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