The prevalence of post-COVID syndrome in patients treated on an outpatient basis ranges from 10 to 35 %; it can reach 80 % in patients with severe coronavirus infection. It is currently hypothesized that long-COVID may be due to both the direct effects of the SARS-CoV-2 virus and the biopsychosocial effects of COVID-19.The aim. To study the characteristics of damage to the central nervous system and mental sphere in patients with comorbid post-COVID syndrome.Materials and methods. To study the clinical features of the course of post-COVID syndrome, 98 patients who had suffered COVID-19 were examined. Of these, 18 (18.4 %) were men, 80 (81.6 %) were women. The mean age in the group was 56.05 ± 1.27 years. The examination program included a questionnaire, clinical examination, pulse oximetry, and assessment of exercise tolerance using the Borg scale. Statistical processing was carried out using the Statistica software package, version 6 (StatSoft Inc., USA). The results of the study are presented as a median, upper and lower quartiles. After analyzing the compliance of the studied indicators with the law of normal distribution (Shapiro – Wilk test), the groups were compared using the Wilcoxon test for pairwise comparison of related samples. Differences were considered statistically significant at p < 0.05.Results. Our studies of comorbidity and complications after COVID-19 infection revealed the most frequent involvement of three systems in the pathological process: cardiovascular, nervous and endocrine. Metabolic syndrome was detected in 67 % and involvement of the cardiovascular system was detected in 48.8 % of those examined.One of the main manifestations of post-COVID syndrome is damage to the central nervous system and mental sphere in the form of mild cognitive and emotional-volitional disorders with asthenodepressive and anxiety-depressive disorders.Conclusion. The health status of patients after COVID-19 is significantly lower than that of the general population. The study results indicate an urgent need to study the pathogenesis of long COVID and develop effective interventions to reduce the risk of its development.

Abstract. Insomnia is a widespread pathological condition in the general population, which has numerous social and medical consequences. Sleep disorders in patients with chronic mercury intoxications are much more common than in the general population. This study aimed to determine the most significant differential diagnostic criteria for sleep disorders in patients with chronic mercury intoxications for their further effective treatment. In this regard, we examined 30 patients with chronic mercury intoxications, whose age averaged 56 0.71 years, and 30 patients of the control group, whose age averaged 54 0.66. All patients underwent clinical, neurological, polysomnographic, and psychological examinations, and neurotransmitters were determined in the blood. Discriminant analysis based on polysomnography, psychological testing and neurotransmitter metabolism revealed significant differences in the examined groups of patients for the following indicators: total sleep time (decreased in the chronic mercury intoxication group) and wake within sleep (increased in the chronic mercury intoxication group) based on polysomnography, blood dopamine level (increased in the chronic mercury intoxication group) as well as reactive anxiety level according to the Spielberger-Khanin scale (increased in the chronic mercury intoxication group). Taking into account the data obtained, it is possible to improve approaches to the diagnosis and treatment of insomnia in the presence of chronic mercury intoxication.

Diabetes mellitus is one of the most serious medical, social, and economic health problems in all countries of the world. The incidence of diabetes mellitus in the world doubles every 10–15 years, acquiring the character of a non-infectious epidemic. Therefore, it is extremely important to search for new drugs that help normalize glycemia, prevent complications of diabetes mellitus, and improve the quality of life of patients. These drugs include “Neo inulin”, which has a hypoglycemic, antioxidant, hepatoprotective and angioprotective effect.The aim: to evaluate the effectiveness of “Neo inulin” in the complex treatment of patients with type 2 diabetes mellitus.Materials and methods. The study involved 18 women (average age – 64.5 ± 8.7 years, average weight – 77.8 ± 11.4 kg) and 3 men (average age – 54.6 ± 12.4 years, average weight – 114 ± 40.2 kg). The average duration of type 2 diabetes was 11.0 (7.0–12.0) years. “Neo inulin” was prescribed as 2 capsules per day for 12 weeks in the complex of basic diabetes therapy To assess the effectiveness of therapy, a study of the quality of life related to health, a biochemical blood test (glycated hemoglobin), a clinical minimum (CBC, OAM, ECG, blood glucose) was carried out, the functional characteristics of tissue blood flow were investigated, and the ankle-brachial index (ABI) was determined. Statistical processing of the results was carried out using the Statistica 6.0 software package (StatSoft Inc., USA). Differences were considered statistically significant at p < 0.05.Results. Statistically significant differences were revealed in the values of all scales of health-related quality of life in patients in the groups before and after treatment with “Neo Inulin”, including the total physical and mental components. An improvement in the functioning of microcirculatory regulation mechanisms was noted, which is confirmed by a statistically significant increase in ABI (1.0 and 0.8 on the right; 0.9 and 0.8 on the left, respectively; p < 0.05) and the coefficient of microcirculation variation (9.2 and 8.3, respectively; p < 0.05). In 57,1 % of cases (12 people), the level of glycated hemoglobin was normalized.Conclusion. The use of a treatment regimen that includes “Neo Inulin” improves the effectiveness of treatment and improves the quality of life of patients with type 2 diabetes mellitus.

Hygienic studies have shown in the cockpit of aircraft and helicopters of crew equivalent levels of sound and vibration in most cases to exceed the maximum permissible levels. There was an exhaustion of the labor process of flight crew members (FCM) due to the high intellectual, sensory, emotional loads caused by the elevated responsibility for safety. The assessment of working conditions of the flight crew can be attributed to their class 3.1-3.4 (harmful working conditions). The clinical and audiological picture showed hearing loss in all subjects to be chronic, bilateral, sensorineural type, slowly progressive, without general somatic pathology, which could lead to hearing loss. The excess of the total physical component of the health-related quality of life (HRQL) over the total psychological component was identified in FCM. The values of the mental health and life activity scores of HRQL were found to be lower than in the comparison group. Evaluation of the psychoemotional status of FCM revealed the adaptive type of attitude to the disease, the lack of social frustration and personality traits predisposing to the development of neurosis and reflecting neurotic changes. The further longitudinal studies are needed to clarify identified socio-psychological characteristics of patients and to develop effective measures of psychosocial and medical rehabilitation that improve the HRQL of the FCM affected by the impact of industrial noise.

Hygienic studies have shown in the cockpit of aircraft and helicopters of crew equivalent levels of sound and vibration in most cases to exceed the maximum permissible levels. There was an exhaustion of the labor process of flight crew members (FCM) due to the high intellectual, sensory, emotional loads caused by the elevated responsibility for safety. The assessment of working conditions of the flight crew can be attributed to their class 3.1-3.4 (harmful working conditions). The clinical and audiological picture showed hearing loss in all subjects to be chronic, bilateral, sensorineural type, slowly progressive, without general somatic pathology, which could lead to hearing loss. The excess of the total physical component of the health-related quality of life (HRQL) over the total psychological component was identified in FCM. The values of the mental health and life activity scores of HRQL were found to be lower than in the comparison group. Evaluation of the psychoemotional status of FCM revealed the adaptive type of attitude to the disease, the lack of social frustration and personality traits predisposing to the development of neurosis and reflecting neurotic changes. The further longitudinal studies are needed to clarify identified socio-psychological characteristics of patients and to develop effective measures of psychosocial and medical rehabilitation that improve the HRQL of the FCM affected by the impact of industrial noise.

Introduction. The vibration disease takes one of the leading places in the structure of the occupational morbidity in the Irkutsk region, its specific weight accounted of 21.1-35.9% of all newly revealed cases of occupational diseases in different years. The purpose of the study is to investigate the socio-psychological features and manifestations of the vibration disease clinical syndromes in local vibration-exposed employees in the dynamic of observation. Material and methods. The assessment of working conditions of employees in the aircraft enterprise, a coherent dynamic clinical and sociopsychological examination in employees with the occupational disease which continuing their work was carried out. Results. Working conditions have not been changed; the levels of the occupational and labor process factors have remained the same in the dynamic. Clinical manifestations of vibration disease and neurosensory hearing loss, which is the second (accompanying) occupational disease, were shown to be aggravated in patients continuing to work in contact with local vibration. A significant prevalence of diseases of the musculoskeletal system and the circulatory system has been revealed. High levels of the personal and situational anxiety, hypochondriacal traits, instability of emotional state, the rigid stereotype of behavior-oriented to caring about physical well-being are registered in patients. A reduction of health-related quality of life scores characterizing the role of physical and emotional functioning has been established, that indicates the limitations in the performance of daily work due to the deterioration of the emotional state. Discussion. The significant prevalence of diseases of the musculoskeletal and circulatory systems in vibration disease patients is associated with both the irritating effect of the actual vibration and the severity of the work process and significant physical overloads. The study results of the psycho-emotional status, the health-related quality of life in vibration disease patients allow assuming a significant effect of the pain syndrome on the emotional state, decrease of the health-related quality of life, which is consistent with the other authors’ studies. Conclusion. The study results show that it is necessary to remove workers from contact with vibration if the initial manifestations of vibration disease appear. Also, it is necessary to revise approaches to the secondary prevention of vibration disease, which should be aimed at preserving residual work capacity and medical and psychological adaptation of patients.

Patients with occupational diseases due to physical and chemical factors underwent treatment by impulse magnetic stimulation. Magnetic stimulation improved interaction between subcortical stem structures and associative regions of frontal and temporal brain lobes. There was shorter time of afferent excitation wave conduction at cervical spine level, and time necessary for activation of near-field neurons in somatosensory cortex, restored impulse conduction velocity on peripheral nerves, lower levels of emotional strain, anxiety, better psychologic comfort in patients. Neurosensory deafness patients demonstrated better audiometry parameters and acumetric data.

The authors evaluated use of three variants of biofeedback technologies in rehabilitation of patients with occupational diseases caused by chemical and physical factors. First variant included a-stimulating training with music therapy for relaxation techniques development, the second - combination of EEG-a-stimulating and temperature myographic biofeedback with music therapy, the third - only EEG-a-stimulating and temperature myographic biofeedback. Before and after biofeedback technologies use according to conventional methods, patho-psychologic, psychologic and physiologic parameters were examined. Clinical effect was estimated according to scale from no effect to considerable improvement of the patients' state. The studies prove prospective use of biofeedback technologies in occupational therapy for rehabilitation of individuals suffering from exposure to chemical and physical factors. The treatment dynamics can be analyzed objectively by physiologic parameters saved during each session on patient's local computer and sent on servers via Internet - that could serve as continuous rehabilitation.

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.

The article covers main results of study concerning life quality in patients with vibration disease and neurosensory deafness. The authors analyzed psychologic types of attitude to the disease, assessed physical, psychologic and social state in patients with occupational diseases, determined role of psychologic component in treatment of such patients.

The article presents main results of studies concerning life quality in individuals having chronic occupational diseases of important social value. Life quality in patients with chronic mercurial intoxication and dust bronchitis appeared to result from personal, social and psychologic features.

The impact of industrial aerosols (fluoride, aluminum oxide dust, coal tar distillates, aromatic and heterocyclic compounds) causes development of broncho-pulmonary pathology in professional workers. The aim of the work was to study the basic indicators of the quality of life and degree of influence of broncho-pulmonary pathology on the health status of patients with diagnosed occupational disease of respiratory system. 38 former employees of the basic professions of electrolysis aluminum production were divided into 2 groups. The first group consisted of 22 persons with FEV1 (forced expiratory volume in 1 second) of 70-80 % of the proper values, the second group included 16 people with fEV1 of 50-69 % of proper values. On the basis of the results of the COPD assessment test the patients of the first group marked moderate (18 %), strong (36 %) and extremely strong (46 %) impact of the disease on their lives. In the second group strong (37 %) and extremely strong (63 %) impact of the disease on patients' lives was registered. Total index of physical component of health in the first group was 37,3 ± 3,5 points, in the second group - 28,9 ± 2,3 points. The results of total index of mental component of health didn't differ significantly in both groups and were 44,1 ± 3,7 and 42,8 ± 2,8 points respectively. It was found that occupational respiratory diseases had negative influence both on summary mental component of health which characterized vitality, social and role functioning and mental health and also on total physical component of health which characterized physical and role functioning and patients' health. In this case lower values of total physical component of health were revealed in patients with moderate disorders of respiratory function in comparison with examined patients with slight decline in FEV1. Thus occupational diseases of respiratory system have negative impact on quality of life of patients and especially on their physical status. The degree of negative impact of the disease on patients' quality of life is determined by the severity of the disease. Functional indicators of respiratory function don't always correlate with subjective evaluation of health status by the patient.

The impact of industrial aerosols (fluoride, aluminum oxide dust, coal tar distillates, aromatic and heterocyclic compounds) causes development of broncho-pulmonary pathology in professional workers. The aim of the work was to study the basic indicators of the quality of life and degree of influence of broncho-pulmonary pathology on the health status of patients with diagnosed occupational disease of respiratory system. 38 former employees of the basic professions of electrolysis aluminum production were divided into 2 groups. The first group consisted of 22 persons with FEV 1 (forced expiratory volume in 1 second) of 70-80 % of the proper values, the second group included 16 people with fEV 1 of 50-69 % of proper values. On the basis of the results of the COPD assessment test the patients of the first group marked moderate (18 %), strong (36 %) and extremely strong (46 %) impact of the disease on their lives. In the second group strong (37 %) and extremely strong (63 %) impact of the disease on patients' lives was registered. Total index of physical component of health in the first group was 37,3 ± 3,5 points, in the second group - 28,9 ± 2,3 points. The results of total index of mental component of health didn't differ significantly in both groups and were 44,1 ± 3,7 and 42,8 ± 2,8 points respectively. It was found that occupational respiratory diseases had negative influence both on summary mental component of health which characterized vitality, social and role functioning and mental health and also on total physical component of health which characterized physical and role functioning and patients' health. In this case lower values of total physical component of health were revealed in patients with moderate disorders of respiratory function in comparison with examined patients with slight decline in FEV 1 . Thus occupational diseases of respiratory system have negative impact on quality of life of patients and especially on their physical status. The degree of negative impact of the disease on patients' quality of life is determined by the severity of the disease. Functional indicators of respiratory function don't always correlate with subjective evaluation of health status by the patient.

The article presents the results of the dynamic clinical observation for persons suffered from occupational chronic mercury intoxication in the remote post-exposure period of the disease. The estimation of the dynamics of syndrome manifestations of chronic mercury intoxication and co-morbidity are presented. The important role of mercury exposure load as a predictor of deterioration of actual health of the patients in the remote period of intoxication is demonstrated.

Biofeedback in toxic encephalopathy in the late period chronic intoxication by mercury and complex toxic substances led to decrease in the EEG changes, performance improvement of the amplitude and latency evoked potentials, in vibration disease – to decrease manifestations of angiodystonia syndrome, recovery of neuromuscular conductivity. The effectiveness of biofeedback is confirmed by changes in subjective measures of the patients.

The article shows the opportunity of use of biomonitoring in patients with exogenous toxic encephalopathy in the remote period of chronic mercury intoxication. (CMI) and with, vibration disease caused by local vibration. The efficiency of the biofeedback method was assessed on the basis of the data of electroencephalography, auditory, visual and somatosensoric generated potentials, electroneuromyography, thermometry, dosed cold test and. rheography. Biofeedback training in people with. CMI caused decrease of total brain changes in EEG, improvement of amplitude indices at of the brain generated potentials, in people with vibration disease it caused decrease of manifestation of angiodistonic syndrome and. restoration of neuromuscular conductivity.

The article deals with the common characteristics of the injured in the result of chronic mercury intoxication, Among them are social psychological problems, lacking of active standoff to disease and striving for cooperation in treatment process. These are the causes of development of psychosocial adaptation, low effectiveness of rehabilitation, deterioration of quality of life. The comprehensive assessment of health related quality of life is proposed. These values can be considered along with objective data in the process of development of individual programs of rehabilitation of the disabled and to serve as a criterion of effectiveness of rehabilitation/

The study results of using the biological reverse connection training with the musical therapy in the rehabilitation of the patients with the chronic mercury intoxication are represented in this paper. The positive effect of the BRC-training on processes concentration of retention, some subscales of the life quality, the functional state of the central afferent conducting structures as well as the neurophysiologic balance of the bioelectrical brain activity have been indicated.