Nº 2 (2022)

Abstract. The aim of the study is to reconstruct the main stages of formation and development of medical and sanitary service of the USSR local air defense, to generalize the experience and to analyze the contribution of medical and sanitary service of the USSR local air defense to organization and rendering of medical aid in the Soviet rear during the Great Patriotic War.

Materials and research methods. The sources for the study were the documents of the Russian State Military Archives: orders, statistical reports, normative documents etc. Application of problem-chronological method allowed to reveal stages, factors and problems of development of the medical and sanitary service of the USSR local air defense of the Ministry of Defense, to reveal changes in its structure, as well as its qualitative and quantitative composition during the stated period.

Research results and their analysis. The research results showed that the period of the Great Patriotic War 1941-1945 was the main stage of formation of the medical and sanitary service of the USSR local air defense as a leading state system of medical and sanitary defense.

Abstract. The aim of the research was:

– to elaborate organizational and methodical bases of medical evacuation for the population of the Altai region in cases of traffic accidents including emergency situations, in conditions of healthcare optimization, namely, under the process of merging of the territorial center for disaster medicine with the emergency medical aid station;

– to determine starting points for further development of the Emergency Medicine Service of the Altai Krai.

Materials and research methods. The statistical data of registration and reporting form no.55 “Information on the Activity of Healthcare Institution (Medical Formation) which took part in liquidation of medical and sanitary consequences of emergencies” of Altai Krai Disaster Medicine Service approved by the Order of the Ministry of Healthcare and Social Development of Russia dated February 3, 2005, no.112, and official statistical data of Altai Krai State Road Safety Department were analyzed. The sample included statistical data for 2019-2021.

The study used a set of analytical and statistical methods, which made it possible to process and to analyze the data obtained, to assess the system of medical care and to develop a set of measures to improve the medical evacuation system in Altai Krai using the data about victims of traffic accidents, to predict the duration of their treatment and rehabilitation. The statistical data were processed by means of Statistica 10.0 program complex with the calculation of intensive indices, mean representativeness error (±m) and significance of differences by Fisher’s method.

Results of the study and their analysis. The results of the analysis of organizational and methodological bases of medical evacuation of the population of Altai Krai in road traffic accidents in the conditions of optimization of healthcare in 2019-2021 are presented. The prospects for further development of the regional Disaster Medicine Service, directions of interdepartmental planning and conducting of special tactical exercises, which are one of the basic tools ensuring readiness of managers and personnel of territorial medical institutions for actions on liquidation of consequences of traffic accidents and emergencies, were determined. The necessity of training the population and interested persons in rendering first aid, which is carried out within the framework of the work of the training center of disaster medicine, has been substantiated.

Abstract. The main algorithms of actions for the medical personnel of the specialized admission department of the Center for Occupational Pathology at the A.I. Burnazyan Federal Medical and Biological Center of the Federal Medical and Biological Agency when admitting patients injured in radiation accidents and incidents are presented. The authors describe in detail issues of decontamination and priority of medical care, routing of patients within a specialized hospital, problems of sanitary and hygienic safety of personnel.

Abstract. The aim of the study was to perform a comparative analysis of COVID-19 epidemic process in selected countries of the world during the first pandemic wave in 2020 and during the rise of SARS-CoV2 variant Omicron.

Materials and research methods. Analysis of the COVID-19 epidemic process was based on data from the Wordometers website (https://www.worldometers.info/coronavirus/#countries). In addition, scientific and popular science articles and official documents on the history, epidemiology, and response to the pandemic in different countries of the world in 2020-2022 were analyzed. The authors’ own observations were also used.

Results of the study and their analysis. Restrictive measures adopted in the People’s Republic of China (PRC), mass screening of the population, observation of those arriving in the country and hospitalization of all those infected made it possible to virtually reduce the circulation of the virus to zero. In the Russian Federation, timely simultaneous epidemic control measures throughout the country resulted in a significant decline in the intensity of the epidemic, both early in the pandemic and after local Omicron transmission, and prevented explosive growth of cases. In the USA, Italy and Sweden, untimely or lenient restrictive measures and low testing during selected periods of the pandemic led to an avalanche of cases and deaths.

Thus the epidemic process of COVID1-9 in the analysed countries depended on the timeliness, duration and extent of restrictive and quarantine measures.

Abstract. The aim of the study was to improve the results of treatment of patients with severe combined trauma of the organs of several cavities (skull, thoracic and abdominal cavities, retroperitoneal space) and of the musculoskeletal system.

Materials and research methods. The study involved 72 patients treated between 2013 and 2017 in a Level I trauma center established at the Republican Clinical Hospital of the Ministry of Health of the Kabardino-Balkarian Republic.

The Injury Severity Score (ISS) index was used to determine the severity of injury; “department of military field surgery, condition, admission” scale was used to assess the state of the injured.

Results of the study and their analysis. Analysis of the findings showed the following: in severe combined injuries the main causes of death are: shock, cerebral edema and dislocation, posttraumatic pneumonia, multiple organ failure, acute respiratory failure, pulmonary embolism and DIC syndrome.

The most satisfactory treatment outcomes can be achieved only with the use of a care tactic based on the principles of staged surgical treatment “Damage control”.

The time frame and the sequence of surgical treatment of injuries depend on their severity, degree of life threatening and prevailing injury.

Abstract. The aim of the study is to substantiate the relevance of the problem of edematous changes in knee joint bones in highly qualified athletes.

Materials and research methods. Materials of the study — relevant literature on edema-like magnetic resonance changes of knee joint bones in highly qualified athletes.

Results of the study and their analysis. Magnetic resonance imaging plays a key role in the differential diagnosis of edema-like bone injuries. It is important to correlate magnetic resonance imaging findings with anamnestic history. In athletes, the peculiarities of diagnosis and treatment of edema-like bone conditions are related to the need to take into account athlete-specific conditions, such as the “athlete’s triad”, and to comply with anti-doping legislation.

It is concluded that it is fundamental to treat the underlying disease that caused the local metabolic disorder in the bone, while techniques aimed at local reduction of the pressure in the bone and at bone metabolism improvement can be used as a supplement. An important factor is the ability of bone tissue to self-repair, which should be taken into account when choosing a treatment method.

Abstract. The aim of the study was to improve the results of treatment of patients with severe combined trauma of the organs of several cavities (skull, thoracic and abdominal cavities, retroperitoneal space) and of the musculoskeletal system.

Materials and research methods. The study involved 72 patients treated between 2013 and 2017 in a Level I trauma center established at the Republican Clinical Hospital of the Ministry of Health of the Kabardino-Balkarian Republic.

The Injury Severity Score (ISS) index was used to determine the severity of injury; “department of military field surgery, condition, admission” scale was used to assess the state of the injured.

Results of the study and their analysis. Analysis of the findings showed the following: in severe combined injuries the main causes of death are: shock, cerebral edema and dislocation, posttraumatic pneumonia, multiple organ failure, acute respiratory failure, pulmonary embolism and DIC syndrome.

The most satisfactory treatment outcomes can be achieved only with the use of a care tactic based on the principles of staged surgical treatment “Damage control”.

The time frame and the sequence of surgical treatment of injuries depend on their severity, degree of life threatening and prevailing injury.

Abstract. The aim of the study is to adapt the method of impedance spectroscopy as applied to the assessment of possible effects of acoustic impact of various parameters.

Materials and research methods. The study was carried out using 70 rabbits (chinchilla) weighing 2.5-3 kg. Five experimental and control groups were formed based on a preliminary examination of the animals in order to cull individuals with altered acoustic stem evoked potential and other parameters. The experimental animals were exposed to five series of 160 acoustic pulses with low-frequency spectrum each.

Results of the study and their analysis. The study showed the promising prospects of using the method of impedansometry in experimental work to assess the impact of acoustic factors on the functional state of the body.

High sensitivity of the method was also proved, allowing to identify difference in the negative impact of acoustic factors of different parameters, which were not identified, in particular, in the analysis of the altered acoustic stem evoked potential.

The results of this work confirmed the need for further research on this phenomenon and for the search for methods of assessing the functional state at the organ and organism levels, correlating with impedance parameters.

Abstract. The aims of the article are to define the world tendencies of medical evacuation by railway transport in the 21st century on the basis of analysis of scientific publications, Internet articles and mass media reports, including those carried out during SARS-COV-2 pandemic; to specify the problems and prospects of development of medical evacuation by railway in Russia taking into account global trends and local specifics.

Materials and research methods. A content analysis of 15 scientific articles, 20 Internet articles, and 31 press communications devoted to individual issues of medical evacuation by railway was performed using the method of nonrepeat sampling.

Selection criteria were: message time — later than January 1, 2001; article should have contained the description of a case/evidence of medical evacuation by railway or the discussion of the possibilities of application of the railway transport for medical evacuation in the 21st century.

Results of the study and their analysis. The world has been conducting medical evacuation by railway for over 150 years. Traditionally, the need for medical evacuation by railway has arisen in case of armed conflicts or large-scale natural disasters, which result in great medical and sanitary losses. In the second half of the 20th century the priority importance of medical evacuation by railway was lost due to the development of automobile roads and aerodrome network and the accompanying development of automobile and air medical transport. The occurrence of emergencies in hard-to-reach areas or the inability of public health systems to organize medical care with a sharp increase in the number of victims in emergencies, including those of infectious nature, determine the need to develop additional mechanisms of medical evacuation. The use of medical evacuation by railway can become this compensatory mechanism. In this connection there has been a shift in the world’s focus in the field of medical evacuation by railway from the use of sanitary trains and flying cars to the formation of mobile medical detachments on the basis of re-equipped passenger trains. The use of re-equipped high-speed electric trains for this purpose has its advantages — it makes possible to avoid organizational difficulties and complications in patients, which are typical for sanitary aviation evacuation, as well as to provide mass medical evacuation of victims without overloading highways with sanitary vehicles. An alternative trend in the development of the medical evacuation by railway is the creation of modern civil sanitary trains and medical carriages. It has been noted that so far Russia does not have technical facilities capable to ensure the up-to-date level of the medical evacuation by railway. The future will show in what way the organization of medical evacuation by railway will develop in our country.