Sergey Anatolievich Babanov

Currently, the following primary forms of mobbing strategies are identified: verbal aggression directed at an employee (provocative questions, false assertions, groundless accusations, questioning of competence, rude and arrogant interruptions, and outbursts of anger accompanied by coarse remarks that demean the individual); and slander (deliberate actions aimed at destroying a person’s personal and professional reputation). Preventing the negative consequences of mobbing is a complex and multifaceted task that requires timely and constructive intervention across the entire hierarchy of an academic institution or healthcare facility. Recommendations for the prevention of mobbing suggest that the administration of a university or healthcare institution should set an example by demonstrating exemplary behavioral standards.

Introduction. According to data from Russian and international studies, functional disorders of the respiratory system, as well as the assessment of markers of lung tissue damage, occupy a central place in the pathogenesis of both hypertension and occupational COPD that develops against the background of long-term exposure to industrial aerosols. These data may, in all likelihood, serve as a key explanation for the progression of occupational COPD, the progression of pneumosclerosis in occupational COPD, and the development of respiratory and pulmonary-cardiac failure in occupational COPD. Materials and methods. The study design provided for four observation groups. The control group (CG) comprised 60 healthy volunteers. Among patients with occupational COPD, the following subgroups were identified: 35 patients with grade I disease severity and 50 patients with grade II. A separate group (n=40) included patients with a combination of grade II occupational COPD (OCOPD) and arterial hypertension (AH). The total number of participants was 185, of whom 125 made up the main cohort of patients and 60 – the comparison group. Expiratory flow parameters were measured: FVC, FEV1, FEV1/FVC, PEF, MEF75%, MEF50%, and MEF25%. The obtained values were expressed as a percentage of predicted values. Symptom severity was assessed using the standard questionnaires – the modified Medical Research Council (mMRC) and COPD Assessment Test (CAT); cough severity was determined using a 10-cm visual analogue scale (VAS); and exercise tolerance was assessed with the six-minute walk test. Surfactant proteins SP-A and SP-D were measured using reagent kits from Biomedica, eBioscience, Bender MedSystems, Technoclone, and R&D Systems (Bl-20052, BMS 277, BMS 2071, BMS 249, Fibronectin ELISA Kit TC 12030, NPO-RENAM) by enzyme-linked immunosorbent assay on an Expert Plus microplate photometer-analyzer (Biochrom, UK). For statistical analysis, one-way analysis of variance (ANOVA) was employed. Between-group differences were assessed with Dunnett’s post hoc test. Differences were considered significant at p<0.05. Results. In this study, the state of the respiratory system and the markers of myocardial damage in patients with occupational COPD were characterized for the first time according to disease severity, and their features were identified in isolated disease and in combination with arterial hypertension. Study limitations. The results are limited by the regional scope (the Samara Region) and by the occupational profile of the examined groups, with their detailed working conditions. Conclusion. From the standpoint of preserving and promoting the health of the working population and maintaining labor potential, for the purposes of pre-nosological examination and prognosis assessment of both OCOPD and its comorbid course, the examination program for individuals exposed to highly dispersed industrial aerosols of toxic-dust etiology should include the determination of indicators characterizing the state of the respiratory system as well as markers of myocardial damage.

The professional activities of doctors specializing in therapeutic and surgical fields are characterized by high neuropsychological stress, as well as growing digitalization — specialists of different generations are not fully adapting to it, which provokes psychoemotional and physical overstrain. Coping strategies are behavioral and cognitive methods of overcoming stress and negative emotions; they are divided into adaptive and maladaptive. The aim of the study is to identify the specific features of the state of the psychoemotional sphere and to assess the level of use of adaptive and maladaptive coping strategies among doctors specializing in surgical and therapeutic fields. Materials and methods: the study involved gastroenterologists (n=52), general surgeons (n=71), cardiologists (n=58), surgeons of the cardiovascular profile (n=30), oncologists of the therapeutic profile (n=48), oncologists of surgical profile (n=65). The control group consisted of non-medical professionals (n=75). The study used the «Coping Test» methodology, which is designed to identify coping mechanisms in the cognitive, emotional, and behavioral spheres [Lazarus R., Folkman S., 1984], adapted by [Kryukova E. V., Kufyat E. V., 2007; Ersh E. V., 2021]. In the statistical analysis, the significance of the differences was determined using one‑way analysis of variance (ANOVA), and intergroup comparisons were made using the Dunnet criterion. The most commonly used coping strategies among gastroenterologists are taking responsibility; among cardiologists, confrontation, self-control, decision-making planning; among oncologists of a therapeutic profile, distancing, seeking social support, escape, avoidance; among surgeons of a general surgical profile, distancing, problem-solving planning; among surgeons cardiovascular profile — confrontation, escape-avoidance, positive reassessment; oncologists of surgical profile-self-control, search for social support, acceptance of responsibility. Excessive use of maladaptive coping strategies leads to maladjustment. The data obtained indicate the need to include questionnaires assessing the use of adaptive and maladaptive coping strategies in the diagnosis of professional burnout in the practice of periodic medical examinations of medical workers, with the aim of timely implementation of preventive measures and their personalization to preserve the health of medical workers.

The article describes the working conditions, clinical presentation, immune profile status, and cytokine regulation associated with vibration disease caused by local vibration exposure, both in isolation and in combination with osteoarthritis, among riveters at an aircraft manufacturing plant. The prognostic significance of changes in the immune profile and cytokine regulation in these conditions was established. It was demonstrated that occupational vibration exposure leads to alterations in all quality-of-life indicators; these changes are most pronounced in cases of stage II vibration disease resulting from local vibration exposure combined with osteoarthritis.

The article describes the clinical manifestations, differential diagnosis, treatment, and prevention of occupational polyneuropathies caused by exposure to occupational vibration, contact ultrasound, physical overexertion, and chemical factors. The role of modern drugs in the pharmacotherapy of occupational polyneuropathies is also discussed.

Occupational eye disorders resulting from functional strain occur during precision work in such sectors as the radio-electronics, precision instrument manufacturing, jewelry, and watchmaking industries. These primarily include quality control and inspection tasks involving the detection of minute defects, as well as professions requiring continuous or prolonged use of optical instruments (microscopes, magnifiers). Such work imposes a significant, and not always physiologically optimal, load on the visual system, potentially causing visual fatigue or exhaustion and leading to temporary or permanent ocular changes. Periodic medical examinations for workers exposed to hazardous chemical or physical factors, or to conditions causing functional ocular strain, must include an ophthalmologist who possesses specialized knowledge in occupational pathology, specifically, advanced training in occupational diseases.

The author identifies the following person-oriented measures of preventing mobbing: conscientious performance of duties; maintaining a friendly attitude toward all colleagues, even those who are hostile; refraining from spreading gossip or demeaning colleagues and subordinates; avoiding setting oneself apart from the team; adhering to societal moral and ethical norms; participating in corporate events and pursuing professional growth; avoiding unnecessary competition; maintaining physical fitness; and mastering stress management techniques, specifically, modifying the social, psychological, and organizational work environment. Organizational and managerial measures for preventing mobbing within work teams include: fostering a healthy organizational culture; maintaining a positive socio-psychological climate; developing managerial skills that prevent the emergence of mobbing; ensuring a rational and clear division of labor between departments to eliminate task duplication or overlap; clearly defining each employee's duties and areas of personal responsibility; establishing a system for personnel advancement and career growth opportunities; and cultivating an attitude of intolerance toward workplace gossip and intrigue.

Occupational chronic obstructive pulmonary disease is distinguished not only by pathological changes in the lungs but also by numerous comorbid conditions that aggravate the course of the underlying disease and complicate its treatment and the implementation of appropriate preventive measures. A review of the literature indicates disturbances in adipokine regulation both in patients with arterial hypertension and in patients with occupational chronic obstructive pulmonary disease, which confirms the important pathogenetic role of these processes in the development and progression of these diseases, and to a certain extent explains the high prevalence of the combination of arterial hypertension and occupational chronic obstructive pulmonary disease in the practice of internal medicine and occupational medicine. The study aims to evaluate indicators of adipokine regulation in patients with occupational chronic obstructive pulmonary disease in its isolated course and in combination with arterial hypertension. Materials and methods. The study involved 175 patients and 60 individuals in the control group: Group 1 (n=60) (control) – healthy volunteers; Group 2 (n=35) – occupational COPD of the first degree of severity; Group 3 (n=50) – occupational COPD of the second degree of severity; Group 4 (n=40) – combination of occupational COPD of the second degree of severity and arterial hypertension; Group 5 (n=50) – isolated course of arterial hypertension. All subjects underwent anthropometric measurements, and the presence of excess weight was assessed by body mass index (BMI). Carbohydrate metabolism status was assessed by fasting venous plasma glucose level using the glucose oxidase method on the "Screen Master Plus" biochemical analyzer (Hospitex Diagnostics, Switzerland). Immunoreactive insulin (IRI) was measured by enzyme immunoassay on the "Architect" device (Abbott, USA). Insulin resistance was assessed using the HOMA index. Leptin and resistin levels were determined by means of the "Expert Plus Asys" microplate reader (Austria). Numerical data analysis was performed in Microsoft Excel, and statistical processing was carried out using SPSS 25 (IBM SPSS Statistics, USA, license No. 5725-A54). The significance of differences in quantitative parameters across three or more groups was determined using one-way analysis of variance followed by intergroup comparisons using Dunnett's test. Descriptive statistics are presented as the mean and its standard error: M±m. Results. For the first time, the features of metabolic changes in occupational chronic obstructive pulmonary disease of varying severity, both in its isolated course and in combination with arterial hypertension, were established. Study limitations. The study has regional (Samara Region) and occupational (based on the detailed working conditions in the comparison cohorts studied) limitations. Conclusions. The combination of occupational chronic obstructive pulmonary disease and metabolic disorders in patients is a serious problem that significantly reduces quality of life and often leads to an unfavorable prognosis. Patients with combined pathology more often experience shortness of breath, have significantly reduced exercise tolerance, and limited physical activity, which contributes to the development of obesity. It is necessary to develop preventive measures and implement specific recommendations for combating metabolic disorders in patients with occupational bronchopulmonary diseases. For this category of patients, in order to reduce the incidence of systemic complications and achieve symptomatic improvement, it is important to develop comprehensive recommendations including rational diet therapy, smoking cessation, drug therapy aimed at treating metabolic imbalance, and pulmonary rehabilitation.

The article is dedicated to the memory of Alexei Dmitrievich Trubetskov, MD, Professor, specialist in occupational diseases, author and reviewer of the journal «Sanitary Doctor», member of the Union of Artists of the Russian Federation, art critic. The contribution of A. D. Trubetskov to the development of modern science and his work in the field of art is described.

Occupational activities involving prolonged, stereotypical, and strenuous hand movements are a leading etiologic factor in the development of stenosing ligamentitis of the dorsal carpal ligament (De Quervain's tenosynovitis). This article presents a clinical case of this occupational disease developing in a female packer, demonstrating the relationship between the nature of the work, clinical and instrumental findings, and professional suitability assessment.