编号 2 (2021)

The creation of an emergency clinical toxicology service in our country led to the need to train clinical toxicologists and to create a specialized Department for this purpose, which was opened in 1985 at the Central Institute of Advanced Medical Training. The staff of the Department carried out a lot of methodological, educational and scientific work, which allowed to achieve a high level of teaching. Successful activity of the Department was promoted by: work on the clinical basis of a multidisciplinary research medical institution – N.V. Sklifosovsky Research Institute for Emergency Medicine; admission to the Institute a large number of patients with various intoxications ensuring thematic completeness of teaching; the unity of command in the leadership of the Toxicological Department of the N.V. Sklifosovsky Research Institute for Emergency Medicine and the Department of Clinical Toxicology of the Russian Medical Academy of Continuous Professional Education in the person of E.A. Luzhnikov, who used his experience in scientific, practical and teaching activities of the Department; due to the existence of the scientific school of academician E.A. Luzhnikov – the development of new technologies for screening, treatment and rehabilitation of acute poisonings; the use of modern teaching methods, including field cycles and distance learning technologies; close interaction with scientific societies, contributing to a significant expansion of the possibilities of new teaching methods.

The character of disturbance of oxidative stress markers and venous blood cells apoptosis in patients with corrosive substances poisoning in early stage was studied. In the first 5 days for the estimation of the oxidative stress severity the lipid peroxidation (LPO) products, antioxidant system (AOS) state and value of the platinum electrode open circuit potential (OCP) were determined. Apoptosis was studied by measuring of apoptotic lymphocytes and dead leukocytes concentration. It was found that in patients younger than 60 years in response to the intake of corrosive substance, peroxidation processes are the first to activate, as evidenced by the oxidative stress development and its increase in dynamics. The apoptosis processes are activated only as oxidative stress severity increase which indicates the development of an adequate reaction to the acute chemical trauma in persons of working age. Contrariwise, in patients older than 60 years apoptosis of venous blood lymphocytes is first activated followed by peroxidation processes activation. Moreover, the low activity of LPO/AOS system is noted in the whole. This fact indicates the absence of an adequate reaction to the intake of corrosive substance in this category of patients.

For persons with occupational diseases who worked at enterprises and organizations served by medical institutions of the FMBA of the Russian Federation, it is relevant to assess their health, taking into account the impact of harmful chemical production factors that have become the causes of their occupational diseases. About 2/3 of cases of occupational diseases caused by chemical hazards are organophosphorus compounds (pesticides), beryllium and its compounds. Of the diseases of non-professional genesis, this group of persons has the highest prevalence of diseases of the circulatory system, musculoskeletal system, digestive and respiratory organs. Of the diseases of the circulatory system, the most commonly diagnosed diseases are those characterized by high blood pressure and coronary heart disease. The structure of diseases of the digestive system is dominated by diseases of the esophagus, stomach and duodenum, diseases of the gall bladder, biliary tract and pancreas. Dorsopathies are the most common within the musculoskeletal disorders; chronic diseases of the upper and lower respiratory tract – within the respiratory diseases.

The toxic effect of poly[3,3-bis(azidomethyl)oxetane] of high molecular weight in subchronic oral intake of white mongrel rats was investigated. It has been found that in a one month experiment the compound at doses of 90,0 mg/kg, 30,0 mg/kg, and 10,0 mg/kg caused a change in the complex of physiological, behavioral, hematological, biochemical, immunological, and pathomorphological parameters in animals. At the same time, the cumulative properties of the toxicant were not registered.
The deviations revealed were dose-dependent. Thus, during the entire period of intragastric administration of the substance, 15 significant changes were noted in the males of the first group, two of which went beyond the 2 sigma deviations in relations to the control values. The same ratio for the second experimental group was 10/1. The oral intake of the substance under investigation at minimum dose was accompanied by 5 violations in the homeostasis of the experimental animals, which did not go beyond the 2 sigma values in relations to the control values.
Taking into account the insignificant number of changes detected and based on the current diagnostic criteria, the dose of 10,0 mg/kg has been accepted as a threshold of subacute general toxic effect for poly[3,3-bis(azidomethyl) oxetane] of high molecular weight.
The obtained data was used when developing the maximum permissible concentration of the estimated component of solid rocket fuels in the water of water bodies.

The nanoscale 20-hydroxyecdysone was first proposed and obtained in the form of a clathrate complex with arabinogalactan with an average particle size of 35,3 nm. The study of its acute toxicity has revealed that the product belongs to class VI of relatively harmless drugs according to Hodge and to class 5^th in accordance with GOST 32644-2014.

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