Medical Radiology and Radiation Safety. 2021. Vol. 66. № 3. P. 29–34

A.A. Ilyin¹, T.A. Fazylova¹, A.P. Dergilev², A.V. Sudarkina², E.E. Olesov¹, V.N. Olesova¹

Radiation Diagnostics in Treatment of Displacement
of a Joint Disk of a Temp-Jaw Joint and Myofascial Disorders

¹ Institute of Continuing Vocational Education functions A.I. Burnasyan Federal Medical Biophysical Center, Moscow, Russia

² Novosibirsk State Medical University, Novosibirsk, Russia

Contact person: Alexandr Alexandrovich Ilyin: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Purpose: Determination of the volume and sequence of radiation studies in the treatment of patients with displacement of the articular disc of the temporomandibular joint (TMJ)and myofascial pain disorders.

Material and methods: The study included 48 patients with displacement of the articular disc of the TMJ and myofascial pain disorders. Clinical criteria for articular displacement were confirmed by MRI and CBCT. Studies of the function of the masticatory muscles were carried out at the Synapsis electromyograph. All patients underwent complex treatment, including relaxation of the masticatory muscles and relief of pain using injections of botulinum toxin in the actual masticatory, temporal and lateral pterygoid muscles (LPM), followed by repositioning split therapy. For the introduction of muscle relaxant in LPM, we have developed and applied external periarticular injection access to LPM. The method is based on reaching the zone of joint attachment of the upper and lower heads of the LPM with MRI navigation. Surveillance continued for up to 12 months with MRI monitoring of the position of the articular disc.

Results: The stages of treatment of SJS of the TMJ with control use of MRI and CT, as well as a method for the administration of botulinum toxin under MRI navigation, have been developed. The first stage included CT and MRI of the temporomandibular joint, the second stage – injections of botulinum toxin into the masticatory muscles using the developed periarticular access to the LPM with MRI navigation, as well as CBCT with a splint to control the new (established) position of the lower jaw; the third and fourth stages included continuation of the reduction splint therapy, correction of the splint, observation for 3-6 months with control CBCT after 6 months to assess the position of the mandible without splint. Achieved an increase in the posterior and upper temporomandibular joint distances and the correct position of the lower jaw.

Conclusion: Performing radiation studies on time at certain stages of treatment, differing in their content and volume, provided a complete diagnosis, planning treatment measures and monitoring the results.

Key words: radiation diagnostics, temporomandibular joint, myofascial disorders

For citation: Ilyin AA, Fazylova TA, Dergilev AP, Sudarkina AV, Olesov EE, Olesova VN. Radiation Diagnostics in Treatment of Displacement of a Joint Disk of a Temp-Jaw Joint and Myofascial Disorders. Medical Radiology and Radiation Safety. 2021;66(3):29-34.

DOI: 10.12737/1024-6177-2021-66-3-29-34

References

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15. Pons M, Meyer C, Euvrard E, et al. MR-guided Navigation for Botulinum Toxin Injection in Lateral Pterygoid Muscle. First Results in Treatment of Temporomandibular Joint Disorders. J Stomatol Oral Maxillofac Surg. 2019;120;3:188-95. DOI: 10.1016/j.jormas.2018.11.002.

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Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 23.12.2020. 

Accepted for publication: 20.01.2021

Medical Radiology and Radiation Safety. 2021. Vol. 66. № 3. P. 13–18

N.A. Metlyaeva, M.A. Lartsev, A.Yu. Bushmanov, I.А.Galstyan, M.Yu. Sukhova, 
L.A. Ryabinina,  E.S. Skorobogatykh, A.P. Kirilchev, O.V. Shcherbatykh, F.S. Torubarov

Psychophysiological Aspects in the Clinical Picture of Disease in Patients
Who Received Local Radiation Injury

AI Burnasyan Federal Medical Biophysical Center, Moscow, Russia

Contact person: Nelli Andreevna Metlyaeva:  This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Purpose: To evaluate in dynamics the psychophysiological adaptation of a patient who received local radiation damage to the tissues of the left half of the chest IV (extremely severe) severity (23 years of observation).

Material and methods: Patient KTS, 66 years old, as the main diagnosis are the effects of local radiation damage to the skin and underlying tissues of the left half of the chest from external radiation (about 3 % of body surface area) IV extremely severe. Before receiving a radiation injury, she was able-bodied and socially adapted, worked as a nurse. In 1996, she was diagnosed with stage I left breast cancer T1N0M0 stage I, in connection with which she underwent a sectoral resection of the mammary gland. Then the patient underwent a course of radiation therapy. By retrospective assessment, the total dose of therapeutic effect before the incident was 10 Gy. At the time of the next session of radiation therapy in connection with the breakdown of the apparatus, a sharp uncontrolled increase in the dose of ionizing radiation (more than 100 Gy) occurred, causing serious injury. The patient was admitted to the Institute of Biophysics Сlinic on the 5th day. Psychophysiological research was carried out with the use of automated software and methodic complex «Expert», designed to study the personal characteristics of a person, cognitive and intellectual personality characteristics in 2001 – 2017 years.

Results: The effects of local radiation damage to the skin and underlying tissues of the left half of the chest from external irradiation of IV (extremely severe) degree in the form of cicatricial-atrophic changes of the soft tissues, with no bone skeleton remain. Disorders of mental adaptation are expressed in the form of senesto-hypochondria disorders, autism of perception, demonstrativeness, apathetic depression and introversion. The most profound contribution to the reduction of the adaptation of the victim is brought about by the features of deep internal disharmony caused by contradictory combinations of demonstrativeness, schizoid traits, anxious depression and affective rigidity.

Conclusion: The data obtained indicate that impaired mental adaptation is an integral part of the clinical picture of local radiation injuries, and reveal the urgent need not only of specific treatment of radiation injury, but also of psychotropic pharmacotherapy and psychotherapy.

Key words: local radiation injury, psychophysiological examination, infringement of mental adaptation

For citation: Metlyaeva NA, Lartsev MA, Bushmanov AYu, Galstyan IА, Sukhova MYu, Ryabinina LA, Skorobogatykh ES, Kirilchev AP, Shcherbatykh OV, Torubarov FS. Psychophysiological Aspects in the Clinical Picture of Disease in Patients Who Received Local Radiation Injury. Medical Radiology and Radiation Safety. 2021;66(3):13-18.

DOI: 10.12737/1024-6177-2021-66-3-13-18

References

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Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 18.11.2020. 

Accepted for publication: 21.02.2021.

Medical Radiology and Radiation Safety. 2021. Vol. 66. № 3. P. 19–28

G.P. Frolov, Yu.A. Salenko, M.I. Grachev, I.A. Galstian, V.N. Klochkov

Decontamination of Victims in the Event of a Radiation Accident
at the Stages of Provision Medical Care

AI Burnasyan Federal Medical Biophysical Center Moscow, Russia

Contact person: Yuri Anatolyevich Salenko: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Purpose: To summarize and analyze the results of research and practical recommendations on the decontamination of victims in the event of radiation accidents, including taking into account the authors’ experience gained in the initial period of the Chernobyl accident (April – August 1986) and in other local radiation accidents (incidents), as well as during emergency exercises.

Results: The indications for carrying out decontamination and the technique of its implementation were considered, a comparative assessment of the effectiveness of skin decontamination agents was presented. Recommendations were formulated for determining the priority (urgency) of carrying out decontamination, depending on the level of external radioactive contamination of the victims. Criteria, rules and methods for carrying out decontamination were proposed for use in relation to the practice of medical and hygienic measures at the stages of medical evacuation (accident site, enterprise health center, enterprise sanitary inspection department, triage site, hospital admission department). The features of decontamination of victims with combined radiation injuries and contaminated wounds (burns) were considered, issues of ensuring the radiation safety of medical personnel who provide assistance to victims are touched upon.

Conclusion: Timely and correctly performed decontamination reduces the exposure of the skin, prevents the entry of radioactive substances into the body and the transfer (spread) of radioactive substances to the subsequent stages of medical evacuation. The main criteria for the urgency (priority) of carrying out decontamination are the levels of radioactive contamination of the skin, contamination nature (radionuclide composition, physicochemical form, etc.) and the presence of victim’s skin lesions (wounds, burns). Decontamination of victims with high levels of radioactive contamination should be considered as a part of the first and subsequent emergency health care and should be carried out as prescribed or with the direct participation of a healthcare professional. At the stages of medical evacuation, decontamination can be carried out if the victim’s condition is stabilized. In the case of a serious condition of the victim, the priority is evacuation to a hospital, while in the prehospital period, as a rule, only partial decontamination of skin areas with high levels of contamination can be carried out. The procedure and rules for decontamination, including the use of skin decontaminating agents, should be reflected in the action plans of the personnel of radiation hazardous enterprises and the plans for medical support of medical units of the FMBA of Russia. 

Keywords: radiation accident, victims, decontamination, radioactive contamination, skin decontaminatio, radiation injury, medical care, dosimetric control, personal protective equipment

For citation: Frolov G.P., Salenko Yu.A., Grachev M.I., Galstian I.A., Klochkov V.N. Decontamination of Victims in the Event of a Radiation Accident at the Stages of Provision Medical Care. Medical Radiology and Radiation Safety. 2021;66(3):19–28.

DOI: 10.12737/1024-6177-2021-66-3-19-28

References

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Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 23.12.2020. 

Accepted for publication: 20.01.2021.

Medical Radiology and Radiation Safety. 2021. Vol. 66. № 3. P. 9–12

O.V. Parinov, A.M. Lyaginskaya, N.K. Shandala, E.G. Metlyaev, V.V. Kuptsov

Problems of Assessing the Health Status of Personnel Working
in Conditions of New Technologies for Nuclear Fuel Production

AI Burnasyan Federal Medical Biophysical Center, Moscow, Russia

Contact person: Oleg Victorovich Parinov:  This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Purpose: To identify the problem of assessing the health status of personnel working under the conditions of new technologies for the production of nuclear fuel.

Material and method: The object of the research was the general morbidity of workers in the production of mixed nitride uranium-plutonium fuel (MNUP-fuel). The material for the study was the data presented in the «Health Passports». The paper used the method of comparative analysis of the overall morbidity of workers in the production of MNUP-fuel and workers in enterprises dealing with nuclear fuel.

Results and analysis: At present, in our country, within the framework of the «Breakthrough» project, new technologies are being developed for the fabrication and refurbishment of mixed uranium-plutonium (MNUP) fuel. In the absence of radiation and hygienic standards for the content of fuel products in working rooms, in order to assess the influence of production factors, along with the radiation dose, the incidence of personnel is studied as an integral indicator of health. A study of the incidence of 50 workers in the production of MNUP fuel revealed: Relatively high incidence of general morbidity – 1122 diseases per 100 people or an average of 93.5 diseases per 100 people per year, regardless of the length of service. The leading diseases in the overall morbidity structure are diseases of the respiratory system – 26.0 % 

(1st place), eyes – 13.4 % (2nd place), musculoskeletal system – 11.4 % (3rd place), circulatory system – 10,9 % (4th place), injuries and poisoning – 8.4 % (5th place), digestive organs and genitourinary system – 7.7 % and 7.0 %, respectively (6th place), which make up 84.7 % of the total morbidity. Obviously, the effective dose of 4.6 mSv/year cannot be the only reason for the high morbidity in workers in complex radiochemical production, but characterizes only the influence of one of the many nonspecific factors of production. The existing system for assessing the health of personnel working in radiochemical production, in addition to analyzing the risks of deterministic and stochastic effects, should include an assessment of the overall morbidity of personnel.

Keywords: personnel, morbidity, mixed uranium-plutonium nitride fuel, integral health indicators

For citation: Parinov OV, Lyaginskaya AM, Shandala NK, Metlyaev EG, Kuptsov VV. Problems of assessing the health status of personnel working in conditions of new technologies for nuclear fuel production. Medical Radiology and Radiation Safety. 2021;66(3):9-12.

DOI: 10.12737/1024-6177-2021-66-3-9-12

References

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Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 23.12.2020. 

Accepted for publication: 20.01.2021.