Extreme Medicine

ISSN Print 2713-2757 ISSN Online 2713-2765

Extreme Medicine

SCIENTIFIC AND PRACTICAL REVIEWED JOURNAL OF FMBA OF RUSSIA

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Zharikov GA, Krainova OA, Khaitov MR, Marchenko AI

Heptyl rocket fuel and aviation kerosene are widely used in the propulsion systems of the Proton and Soyuz spacecraft. The propellant components (RFC) enter the environment, causing strong toxic effects, when the separating first stages of rockets fall away or in case of emergencies. The study was aimed to isolate strains of microorganisms-destructors of RFC, as well as to assess their safety for bioremediation of contaminated soils. Microorganisms capable of decomposing heptyl, formalin, and aviation kerosene were isolated from natural soils. An association of two strains of bacterial destructors Pseudomonas putida 5G and Rhodococcus erythropolis 62М/3 was obtained, and a method of their use in recultivation of soil contaminated with RFC was developed. The results of laboratory and field tests showed high efficiency of the microbial destruction of pollutants, the decrease in integral toxicity and phytotoxicity of the cleaned soil to safe levels, and an increase in the soil biological activity. Thus, dehydrogenase activity increased by 2.4 times, hydrolase activity by 2.1 times, and cellulase activity by 5.1 times. Microbial association can be recommended for recultivation of soil contaminated with RFC.

Received: 2022-06-22

Published online: 2022-09-15

DOI: 10.47183/mes.2022.031

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VIEWS 1449

Lyang OV, Pakhilova-Popova AV, Kabaeva AR, Boiko OV, Shamalov NA

To date, Streptococcus мassiliensis, the representative of human oral normobiota, was detected in the patients' blood only twice (which was confirmed by the reports published in 2004 and 2015). The patient with the demyelinating disease of the nervous system was routinely admitted to the neurological department for further examination and treatment. The diagnosis of meningoencephalitis was established based on the laboratory and instrumental tests. Meningoencephalitis was later complicated by bilateral multilobar pneumonia, systemic inflammatory response syndrome, and multisystem organ failure. After sharp deterioration of patient's health in the form of the decreased level of consciousness and brainstem symptoms, cerebrospinal fluid was tested by PCR for markers of viral and bacterial infections, and blood was cultured. Bacterial growth was detected in blood culture, and then Streptococcus massiliensis, susceptible to benzylpenicillin, vancomycin, levofloxacin, linezolid, sulfamethoxazole/trimethoprim, and erythromycin, was identified by time-of-flight mass spectrometry. Thus, it seems necessary to focus attention on this case of the Str. massiliensis isolation from blood due to the near total lack of data on the Str. мassiliensis biological role and the more frequent isolation of bacteria of the genus Streptococcus from sterile human body fluids.

Received: 2022-07-15

Published online: 2022-09-08

DOI: 10.47183/mes.2022.030

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VIEWS 1506

Kochubey AV, Yarotsky SYu, Kochubey VV, Evdoshenko OA

Successful management cannot take place without soft skills. The study was aimed to assess the frequency of using soft skills by heads of clinical departments based on feedback from physicians working at the departments. For that an online survey of 433 physicians was conducted with the use of the questionnaire taken from the 360 Sample Competencies Guide. The questionnaire included 20 statements divided into five items: self-awareness, drive for results, leadership, communication, teamwork. The respondents were given five response options per statement: from “always” to “never”. The clue referred the assessed individual to one of five groups based on the frequency of using soft skills: leaders, key management, typical management, underachievers, outsiders. Nonparametric methods of analysis were used for data processing. Based on the survey data, 8.6% of assessed individuals joined the group of leaders, while 15.8% were referred to the group of key management, 23.4% to the group of typical management, 30.3% to the group of underachievers, and 21.9% to the group of outsiders. The scores of items correlated with each other (0.973 ≤ R ≥ 0.967; р < 0.001). The respondents’ age, years of service and gender (р > 0.05), as well as the assessed individuals’ gender (р > 0.05) provided no significant differences between the scores. The scores obtained for “communication”, “teamwork”, emotional control, setting challenging goals, and prioritizing work were lower in the hospital-based physicians than in those who worked in outpatient settings (р < 0.05). The questionnaire can be recommended as a feedback tool. Soft skills of the department heads require further development. Soft skills that belong to the items “drive for results”, “leadership”, and “self-awareness” are worst affected.

Received: 2022-07-02

Published online: 2022-08-23

DOI: 10.47183/mes.2022.029

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VIEWS 1438

Diab KhMA, Daykhes NA, Pashchinina OA, Zukhba AG, Kokhanyuk SV, Pirogova NE

Pneumolabyrinth is characterized by the presence of air in the inner ear due to intrusion from the tympanic cavity. It is a rare complication of stapedoplasty. Currently, there is no clear algorithm for treatment of this complication. The paper reports two cases of pneumolabyrinth being the short-term and long-term postoperative complications. In the first case, the patient, who had undergone stapedoplasty in the left ear, suddenly developed rapid hearing loss and tinnitus in the left ear with dizziness three weeks after physical activity. Physical examination revealed no evidence of the tympanic membrane defect. Audiometry revealed left-sided IV degree of sensorineural hearing loss. Pneumolabyrinth was detected on the temporal bone CT scans. In the second case, vestibulocochlear symptoms developed three days after stapedoplasty in the right ear. Pure tone audiometry revealed right-sided IV degree of mixed hearing loss. CT scan of the temporal bone confirmed the diagnosis of pneumolabyrinth. In both cases the correct position of the stapedial prosthesis, "empty" vestibule and perilymphatic fistula were found during revision tympanotomy. The prosteses were removed during surgery, Dexamethasone solution was introduced into the vestibule; stapedoplasty with autocartilage on the perichondrium was performed. After surgery, vestibular symptoms disappeared, and hearing improved.

Received: 2022-06-14

Published online: 2022-08-16

DOI: 10.47183/mes.2022.028

Comments 0

VIEWS 1715

Nikiforov VS, Blinova EA, Akleyev AV

In addition to damaging the genetic apparatus of the cell, ionizing radiation can cause epigenetic alterations. DNA methylation that plays a vital part in regulation of cellular processes is a common epigenetic modification. DNA methylation ensured by DNA methyltransferases occurs in the CpG-rich sequences. The study was aimed to assess mRNA expression of genes encoding DNA methyltransferases (DNMT1, DNMT3A, DNMT3B) in the chronically exposed individuals who live along the River Techa over a long-term period. A total of 112 people were examined more than 65 years after the beginning of chronic exposure. The average accumulated dose to red bone marrow (RBM) was 782.0 ± 82.3 mGy, and the average accumulated dose to thymus and peripheral lymphoid organs was 93.2 ± 13.6 mGy. The subjects' age at the time of examination was 67.9 ± 0.8 years (54–83 years). The relative mRNA levels for the studied genes were assessed by realtime polymerase chain reaction (real-time PCR). mRNA expression of DNMT1 correlated positively with the dose to RBM (p = 0.04), thymus and peripheral lymphoid organs (p = 0.02), as well as with the dose rate in these organs (p = 0.05, p = 0.04, respectively) during the period of the highest levels of radiation exposure. In individuals exposed in the high dose range (over 1000 mGy) there was a significant increase in the expression of DNMT1 mRNA compared to the comparison group (p = 0.02). The findings may indicate the DNMT1 gene involvement in epigenetic alterations that occur in the chronically exposed people in the long term.

Received: 2022-06-29

Published online: 2022-08-09

DOI: 10.47183/mes.2022.027

Comments 0

VIEWS 1781

Patients with chronic heart failure (CHF) constitute the bulk of the group at the highest risk of sudden death (SD). The majority of SDs occur at night. However, CHF grade and ejection fraction do not always determine the risk of SD in the outcome of the disease. The following view has been expressed based on the research on the topic and the described mechanisms underlying SD: impaired QT interval adaptation (“hyperadaptation”: QT/RR slope > 0.24) to HR in patients with CHF who show maximum QT interval prolongation during the night, capable of triggering life-threatening ventricular tachyarrhythmias that trigger the mechanism of SD associated with CHF, can play some role. It is possible that identification of QT interval hyperadaptation in patients with CHF makes it possible to form the group at high risk of SD associated with HF and can become an additional indication for implantation of cardioverter-defibrillator.

Received: 2022-07-06

Published online: 2022-08-09

DOI: 10.47183/mes.2022.026

Comments 0

VIEWS 1414

Bukhtiyarov IV, Pankova VB, Fedina IN, Daykhes NA, Bomshteyn NG

Occupational hearing loss in the civilian flight crew members prevails in the structure of occupational hearing loss. The study was aimed to assess errors made in forensic evaluation of flight personnel with hearing loss. A total of 213 definitive diagnoses of occupational hearing loss established in 2015–2021 were assessed. Expert errors were found in 73% of cases. The most common, typical errors were reported that were evident in 12 cases submitted for forensic evaluation. The main errors were as follows: incorrect assessment of the parameters of noise inside the aircraft cabin, lack of knowledge about the clinical and audiological features of noise-induced hearing loss, incorrect assessment of audiological indicators, underestimation of the role of comorbidities, etc. The findings showed that high proportion of occupational hearing loss in the civilian flight crew members was in large part due to imperfection of expert solutions resulting from the lack of knowledge about the basic criteria of the diagnosis and the relationship between the noise-induced hearing loss and profession. The major requirements for evaluation of the relationship between the noise-induced hearing loss and profession and the issues related to professional suitability set out in the current regulatory documents issued by the Ministry of Health of the Russian Federation and seminal publications were not taken into account. The cornerstones of expert work on the issues of the relationship between the hearing organ disorder and profession in the civilian flight crew members were underestimated. This resulted in unsubstantiated professional unsuitability, disability among working-age people, and economic losses.

Received: 2022-07-02

Published online: 2022-07-31

DOI: 10.47183/mes.2022.025

Comments 0

VIEWS 1525

Objective diagnostic assessment of the human thought processes is an important issue of modern neurophysiology. The study was aimed to develop a system to analyze visual gnostic processes as a model of higher nervous function. A total of 30 people aged 30–60 having no acute disorders, exacerbations of chronic disorders or significant vision problems were examined. Electroencephalography analysis included EEG artifact removal, clustering and distinguishing specific EEG microctates according to the selected model with subsequent localization of the main source of activity, that had generated the EEG microstate, through the algorithms for solving the inverse EEG problem implemented in the sLORETA software package. When running the visual gnosis test (looking at written symbols), activity was recorded within a larger number of Brodmann areas compared to the state of relaxed wakefulness. Activity was detected within Brodmann areas 18 and 19 (11 and 45%, respectively) responsible for visual perception of images, area 39 being a part of Wernicke's area (6%), and the structures of premotor and prefrontal areas (areas 6–11) (up to 11%) (p < 0.001; Pearson's chi-squared test). Microstates defined when a subject is in a state of relaxed wakefulness or under visual load are not identical. Rather these are gauge derivatives of clustering in the context of used mathematical model. Solving the inverse EEG problem at the final stage of the study makes it possible to define the average sequences of rhythmic activity associated with realization of visual gnostic function.

Received: 2022-05-31

Published online: 2022-07-19

DOI: 10.47183/mes.2022.024

Comments 0

VIEWS 1610