[Functional activity of the brain depending on the degree of severity occupational noise-induced hearing loss]. / Funktsional'naya aktivnost' golovnogo mozga v zavisimosti ot stepeni vyrazhennosti professional'noi neirosensornoi tugoukhosti.

Research objective identification of the peculiarities of indicators of audiological examination, registration of somatosensory induced potentials (SSSP), level of constant potential (LCP) and neuropsychological testing in persons of flight composition (LLS) of civil aviation exposed to intra-cabin noise, depending on the degree of expression of professional neurosensory noise (ONIHL). PATIENTS AND METHODS: Thresholds of acoustical sensitivity, levels of perception of shepotny, informal conversation, UPP, characteristic of SSVP, neuropsychological features at 45 patients with easy degree of PNST (LONIHL) and at 50 - with moderate degree of ONIHL (UONIHL) are studied. RESULTS: LCP in the left frontal (Fs), central dark (Pz) leads increased in persons with ONIHL, and the inter-peak interval of the N13-N20 characterizing the central conduct time increased. The FAB, unlike the LONIHL, is characterized by deterioration of cognitive activity in the form of easily pronounced decrease of visual memory functions, expressive speech, FAB scale value indicating priority dysfunction of frontal, dark-occipital lobes, subcortical cerebral structures. CONCLUSION: Neurofunctional markers in UONIHL are the reduction of the indicators of the interfamily relations on the frontal department, conceptual thinking, visual image memory, expressive speech, MMSE and FAB tests, the increase of LCP in the left temporal, central dark, occipital right central N13-N20, inter-peak N25.

[Comparative characteristic of cognitive impairment at alcoholic and discirculatory encephalopathy]. / Kharakteristika kognitivnykh narushenii pri alkogol'noi i distsirkulyatornoi entsefalopatii.

OBJECTIVE: Identification of features of cognitive impairment at patients with alcoholic and discirculatory encephalopathy. MATERIAL AND METHODS: 30 patients with the alcoholic encephalopathy (AE) and 32 - with discirculatory encephalopathy (DE) participated in research. To patients conducted clinical examination, a computer electroencephalography with determination of cognitive evoked potentials, neuropsychological testing. RESULTS: General and distinguishing characters of a clinical picture, cognitive deficiency, disturbances in the emotional and personal sphere at patients with encephalopathies alcoholic and vascular genesis are established. CONCLUSION: It is established that a basis of a clinical picture of encephalopathy of various genesis are the cognitive disturbances (CD) and an asthenic syndrome, of AE it is characteristic hyposthenic, and at DE - hyper - and hyposthenic syndromes. Changes of bioelectric activity of a brain at DE had primary localization in occipitoparietal departments of a brain, at AE - in temporal and occipitoparietal assignments. Disorder of categorial thinking, the long-term memory, reciprocal coordination, manual gnosis indicating dysfunction by a frontal, parietal lobe of the left hemisphere, a hippocampus, a corpus collosum are provided to CD in DE and AE patients. It is established that distinguishing characters of CD in AE and DE patients are values of indexes Δ-, ß1-, ß2-rhythms, the indicators characterizing the impressive speech, volume of visual figurative memory, level of severity of hypochondria.

[Interrelation of rates of a biological aging with neurophysiological features at patients with professional neurointoxications].

In the hospital conducted studying of functional activity of a brain of patients with professional neurointoxications for the purpose of detection of neurophysiological features of formation of the accelerated rates of biological aging at the working, being affected neurotoxicant is carried out. During the research it is shown that rates of aging at patients with professional neurointoxications on average in 85% of cases have premature character. The general signs of defeat of structures of a brain at professional intoxication are defined by mercury irrespective of a disease stage at the accelerated biological aging. For toxic impacts on a nervous system the characteristic, uniting sign distinguishing from the accelerated rates of aging of other etiology is the indicator characterizing augmentation of a latence of peak of P2 of the visual caused potentials. Based on the analysis of the received correlations it is set that in case of professional neurointoxications permanent disorganization of the functional activity of a brain in the form of cortical and subcortical violations of sensor regulatory systems of a brain is a consequence of chronic influence of vapors of metal mercury and a complex of toxic substances and the reason of the accelerated biological aging.

[Emotional and physiologic features of civil aviation pilots with neurosensory deafness].

The article presents results of evaluation concerning neurophysiologic and psychoemotional state of pilots with occupational neurosensory deafness. Findings are that pilots with occupational neurosensory deafness demonstrate disorganized type of EEG, supported by fading alpha-rhythm, increased slow wave activity in delta range. Other changes are decreased conduction velocity in distal part of median and ulnar nerves - that indicates development of demyelination processes. Psychologic studies proved that personality structure in pilots with occupational neurosensory deafness has dominant traits of balanced emotional reactions, constructive ways to overcome difficulties.

[Role ofneuroautoimmune integration in pathogenesis of vibration disease].

Clinical immunologic and electroneuromyographic examination covered patients with vibration disease. Registered- demyelination disorders on lower and upper limbs in vibration disease patients were associated with neurochemical changes in special neural structures (OBM, S-100 protein, DNA, AH-R, DA-R, Ser-R, GAMK-R). Direct proof of demyelination disorders in vibration disease patients are reliable correlation between levels of antibodies to OBM and conduction velocity in distal part of median nerve, in ulnar nerve from elbow bend and lower third of arm, and ulnar residual latency. Diagnosed relations between levels of antibodies to regulatory proteins in nervous tissue (antibodies to OBM and to S-100 protein), neurotransmitters (antibodies to AH-R, DA-R, Ser-R, GAMK-R) and functional parameters of nervous system prove important role of autoimmune reactions in vibration disease pathogenesis.

[Legal aspects of examination concerning complicated cases of occupation connection with disease].

The article deals with problems arising in consideration of relations between disease and occupation. The authors presented and analyzed legal occupational therapy documents that regulate examination for connection between disease and occupational activities. Consideration also covers legal aspects and solutions of debates in complicated examination cases with specific clinical examples of legal expertise, based on experience of FGBNU VSIMEI personnel.

[Dynamic follow-up of health state in workers of railway tunnel].

The article covers results of examination in workers engaged into railway tunnel exploitation, for health state features, in dependence on occupational factors, character and intensity of somatic diseases. The authors evaluated frequency of instrumental parameters change, analyzed clinical symptoms at manifestation and advanced disease, and its dynamics.

[Mechanisms underlying changes in state of central nervous system pathways under exposure to metallic mercury].

The authors revealed mercury role in pathologic changes of central mechanisms underlying cerebral circulation in metabolic circle, associated with changes in central afferent pathways in thalamic region. Relationship was established between intensity of the diagnosed affect and changes in levels of antibodies to proteins S-100, general myeline protein, myeline-associated glycoprotein - that can indicate general neurodegeneration process. Antibodies level can serve as a marker of demyelination intensity in central pathways under exposure to neurotoxicants.

[The dynamics of the occupational morbidity rate in the Eastern Siberia].

The dynamics and structure of the occupational morbidity rate in main branches of the industry in the Eastern Siberia for the 2000-2015 (on the example of the Irkutsk region) is presented in this paper. During the observation period there were noted the significant gain in the number of cases of occupational diseases registered in such different branches of industry as Coal and Lignite Mining, ship and aircraft building, and in some other branches (metallurgical production, air transport, pulp production, electric power distribution industry). In the structure of the occupational morbidity leading positions are occupied by diseases associated with the exposure to physical factors, industrial aerosols, physical overload and overexertion of certain organs and systems. The main reasons and factors contributing to the gain of the occupational morbidity rate are the imperfection of technological processes, working places, personal protective equipment and/or their lack, constructive defects of machines and equipment, the violation of safety regulations, regimen of the work and rest, insufficiently high level of medical and preventive maintenance, delayed making of decisions for the rational employment to the workers with the revealed early forms of occupational diseases. There pointed out priority directions of the prevention the implementation of which will allow to decline the level of the occupational morbidity rate. The main directions are the implementation of economically caused mechanisms of the interest in the preservation of workers ' health; implementation of the regional aimed programs; the introduction of new processes, equipment and mechanisms meeting modern hygienic requirements; the assessment of occupational risk with the creation and implementation of the system of monitoring for the dynamics of working conditions and the state of the workers ' health for the making corrective management solutions on the optimization and elevation of the efficacy and relevance of developed and implemented preventive health measures.

[Modern aspects of the conservation and promotion of health of firefighters].

On the basis of complex hygienic studies there were determined conditions of the work of firefighters in liquidation of foci of fires at the incipient stage, identified the complex of toxic substances, their quantitative content in the area of the smoke of fires. The analysis of the etiological role of occupational factors in the shaping of the morbidity and the physiological and clinical manifestations, established indices of the risk for occupational and industrial-caused pathology have allowed to substantiate the relationship of a number of nosological forms associated with working conditions of firefighters. There was developed a system of preventive activities for the promotion and preservation of the health of firefighters, as well as a conceptual model for monitoring of working conditions and state of health.

[Vibration disease: hygienic and medical aspects].

The hygienic assessment of working conditions of employees exposed to local vibration established that working conditions for employees ofvibration dangerous occupations at the aircraft plant according to the degree from a health standpoint and hazard are referred to the fourth (dangerous) class of the degree of danger that stipulates stable high levels of the morbidity rate. The leading factor is a local vibration that results in the consistently high levels of occupational morbidity rate. There was shown the efficiency of the use of the pulsed magnetic stimulation in the treatment ofpatients with vibration disease associated with the exposure to local vibration. For the evaluation of the effectiveness of treatment in patients the condition of the central nervous system was determined with the use of computer electroencephalography with the registration of visual and auditory evoked potentials and somatosensory evoked potentials; there was studied the state of the peripheral nerves in arms and legs relying upom electromyographic data; there was performed psychological study. After the performance of pulse magnetic stimulation in patients diagnosed to have the vibration diseases there were observed the improvement in the interaction of cortical-subcortical structures and associative areas of the frontal and temporal lobes of the brain. After treatment there was noted the shortening of the time of the conduction of the afferent wave of the excitation at the level of the cervical spinal cord, subcortical structures and the central conduction time. There was restored previously reduced the speed of the conduction of the impulse via the distal parts of the tibial and median nerve, through the ulnar nerve in the area of the elbow joint. There was noted the rise in the average temperature on the hands; the decline of thresholds of vibration and pain sensitivity; the improvement of indices characterizing of the state of mnestic- attentional and psycho-emotional scope of activity.

[State of central and peripheral conduction tracts in patients with long-term chronic mercury intoxication].

In connected sample, the authors studied changes in state of peripheral nerves (electroneuromyography) and central afferent conduction tracts (somatosensory evoked potentials) in patients with long-term chronic mercury intoxication. The study helped to reveal negative changes in peripheral and central afferent conduction tracts in the patients with long-term chronic mercury intoxication, more marked in 3 period of the study--demyelination of sensory and motor components of peripheral nerves and longer impulse propagation time in conduction tracts of subcortical and cortical structures of somatosensory brain cortex.

[Diagnostic value of neuronal auto-antibodies and neurodegeneration of central conduction tracts in exposure to metallic mercury vapors].

Stationary medical examination covered chemical production workers (47 individuals) with long length of service, exposed to metallic mercury vapors, and patients in remote stage of chronic mercury intoxication (51 individuals). The examination included registration of somatosensory evoked potentials and levels of neuronal antibodies. Analysis of results helped to reveal relationship between intensity of structural disorders involving central afferent conduction tracts and changes in levels of auto-antibodies to S-100 proteins, general myelin protein, myelin-associated glycoprotein--that can indicate general neurodegeneration process in central structures. Level of neuronal antibodies can serve as a unique marker of demyelination intensity of central conduction tracts under exposure to neurotoxic chemicals and considerably decrease cost of examination during regular medical checkup.

[Cognitive disorders in toxic (mercurial) and alcohol encephalopathy].

To differentiate cognitive disorders in toxic (mercurial) and alcohol encephalopathy, the authors determined peculiarity of mental disorders in patients with toxic encephalopathie of various origins. Discriminant analysis helped to evaluate totality of informative neurophysiologic and psychologic parameters to assign patients to a group with cognitive disorders due to mercurial toxic encephalopathy or to a group with that due to alcohol encephalopathy.

[Cognitive impairment in a toxic lesion of the brain].

OBJECTIVE: To identify features of cognitive impairment in patients with toxic (mercury or alcohol) encephalopathy. MATERIAL AND METHODS: The study involved 36 patients with chronic mercury intoxication and 30 people with chronic alcoholism. A control group included 30 age-matched healthy men who were not exposed to toxic substances and alcohol abuse. All patients underwent neuropsychological examination, which involved a set of neuropsychological Luria rated memory status, praxis, gnosis and speeches. MMSE and FAB were used for the diagnosis of moderate cognitive impairment. Computer electroencephalography and cognitive evoked potentials method were used as well. RESULTS AND CONCLUSION: The diffuse brain injury in toxic encephalopathy (alcohol and mercury) on EEG, and according to the results of neuropsychological testing was identified. Changes in analytical and synthetic thinking, audio-verbal, long-term, visual memory, reciprocal coordination, finger gnosis, impressive speech were observed in mercury encephalopathy. Functional failure of the frontal lobe and the premotor area of the left hemisphere were revealed in alcoholic encephalopathy.

[Occupational neurointoxications: patterns and mechanisms of formation].

The article covers results of long-standing study of clinical features of occupational neurointoxications in late period, and mechanisms underlying nervous system disorders in individuals working under long exposure to neurotoxic chemicals and in late period of occupational intoxications. With modern neurophysiologic, neuropsychologic, immunologic and biochemical diagnostic methods, the authors specified early manifestations of occupational disorders. Translation patterns of neurointoxications are specified.

[Cognitive disorders in patients with chronic mercury intoxication].

To assess severity of cognitive disorders in chronic mercury intoxication, the authors performed claster and discrimination analysis of neuropsychologic and neurophysiologic research data from workers exposed to mercury during long length of service, from patients with early and marked stages of chronic mercurial intoxication. Cognitive disorders in chronic mercurial intoxication have three severity degrees, in the light degree disorders patients demonstrate lower amplitude of cognitive evoked potentials, poor long-term memory and associative thinking. Moderate cognitive disorders are characterized by decreased visual, long-term memory, concentration of attention, poor optic and spatial gnosis. Marked cognitive disorders with chronic mercurial intoxication present with more decreased long-term, short-term, picturesque memory, poor intellect, optic and spatial gnosis and associative thinking.

[Diagnosis and treatment of polyneuropathy].

The electroneuromyographic examination of patients with the occupational polyneuropathy of the extremities after the exposure to the whole-body and local vibration has been performed with the aim to reveal the diagnostic indices of polyneuropathy severity under stationary conditions. The main diagnostic criteria of polyneuropathy severity have been revealed using the discriminant analysis. The drug gabapentine (tebantine) has been tested as the basic pharmacotherapy.

[Bioelectric brain activity under exposure to vibration].

Patients with vibration disease caused by local vibration and those with the disease caused by general vibration demonstrate similar changes in regulation of central nervous system, as shown by EEG--diffuse changes and locus of pathologic activity mostly in right temporal cortex. Unlike local vibration, the combined one acting long (over 10-15 years) causes more pathologic changes in brain, not only in cerebral cortex, but also in brainstem and diencephalic structures.