The medical service of the Red Army entered the Great Patriotic War with some experience of combat work in the recent Soviet-Finnish War with unfinished organizational restructuring and had o improve their organization, principles and forms of work, train medical personnel in the course of the "great war". It is appropriate to note that total losses of medical staff make up 210 thousand 601 persons, including 84 793 (40.3 %) irrecoverable losses and 125 thousand 808 (59.7 %) sanitary casualties. The most important part of a unified system of medical support for combat operations of the Red Army, which is closely related to the medical evacuation process is their hygiene and disease control. The main task was to urgently create full-fledged hospital database in each army with sufficient capacity and the ability to provide basic kinds of specialist medical care and organization of in-situ hospital treatment for all categories of the sick and wounded with recovery terms not more than 20–30 days. It was important for the actual implementation of the fundamental principle of medical support of the Red Army in the war – stage treatment with the evacuation as indicated. During the war, 598 mobile surgical field hospitals, 151 therapeutic field mobile hospitals, 154 infectious mobile field hospitals, 295 hospitals for lightly wounded (as of July 01, 1944) and evacuation hospitals for a total of 1 million 914.1 thousand beds were deployed and integrated into general medical evacuation system. General military inventory including bandages, surgical instruments, medicines, anti-epidemic, medical equipment, sanitary assets is provided. The Red Army received serious support from allies ("lend-lease"). The total number of sanitary losses in the Red Army during the war reached 18 million 320 thousand, irrecoverable losses – 11 million 273 thousand. Due to joint efforts of both military and civilian medical personnel, 71.7 % of injured and 86.7 % of diseased (10.5 and 6.6 million people, respectively, more than 17 million in total) were returned to duty.

Disaster Medicine Service (DMS) of St. Petersburg is the territorial organization of the All-Russian Disaster Medicine Service. It is an integral part of the city health system and ensures the provision of health care to the population in emergency situations (ES). At the city level, DMS is headed by Chairman of the Health Committee of St. Petersburg. Forces and assets of the city DMS work in the following modes: high alert – under the threat of a disaster; emergency mode – in case of occurrence and liquidation of health consequences of emergencies; daily activities – in the absence of the threat of a disaster. During the daily activities and high alert, the readiness of the DMS is checked and organizational-methodological management is provided by the territorial Center of Disaster Medicine (CDM), based at the city ambulance station of St. Petersburg, which receives the necessary information about medical conditions through the duty officer of the municipal Health Committee. To solve the problems in emergencies, the CDM of St. Petersburg has the appropriate forces and assets: 1) mobile detachments: 160-170 teams of the City ambulance station, up to 350 district staff mobile teams for emergency medical assistance; 64 non-staff teams of urban clinics (doctors and nurses); 28 specialized medical teams on high alert; 42 specialized teams of emergency medical assistance; 18 medical modules of administrative districts; 2) 5,000 beds (including 900 beds for children) at 46 general and specialized hospitals of the city; 3) forces and assets of transport service, blood and blood substitutes, medical and sanitary inventory; 4) interacting subjects: Northwest Department, EMERCOM of Russia and the Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia, the Kirov Military Medical Academy, the medical service of the Northwest Military Region of the Russian Defense Ministry and the General Directorate of Internal Affairs for St. Petersburg and Leningrad region, as well as the medical service of the October Railway, the Leningrad Region, and others. When mitigating the health effects of emergencies in St. Petersburg, these forces and assets allow medical care to be provided to victims at the prehospital and hospital stages.

In order to assess the relationship between disorders of the immune system and degree of stress severity 31 rescuers of the Ministry of Emergency Situations of Russia as well as 30 civilian patients with diseases of the gastrointestinal tract (GIT) were examined. The control group consisted of 28 practically healthy rescuers and 29 civilians. Psycho-diagnostic methods were used to analyze stress levels experienced by rescuers of the Ministry of Emergency Situations. Rescuers with gastrointestinal diseases are characterized by a decline of interest in their professional activities, in general mood, in self-confidence and by pronounced emotional stress. Also, they are characterized by deterioration of health, psychosomatic health complaints, a high level of anxiety and depression. Reduction of humoral immunity was identified in both examined rescuers groups in comparison to the corresponding group of civilians. This was caused by significant reduction in indicators of IgA, IgG. One of the further characteristics of rescuers with GTI diseases is their decreased cellular immunity and phagocytic index. The analysis data of the correlation between psychological and immune states suggests that endured post-traumatic stress disorder is a predictor of psychogenic-related diseases of the gastrointestinal tract.

During current military conflicts, vessels are injured in 10–22 % of patients with gunshot injuries of extremities; this is one of the main causes of death during the war. Results of 376 operations to restore the blood flow in vessels were analyzed in 342 injured. 243 arterial and 13 venous vessels were sutured. The operations proceeded in specialized hospitals. In most cases, diameters of the vessels were less than 2 mm. Vein transplants were used for the plastic of the gunshot artery defects of 1–5 cm length. Technique of vessel suturing (separation of the injured vessel ends with further cutting their ends, holding them and suturing with microsurgical tools and optical magnifying devices) helped to restore circulation in 95.5 % of wounded.

Catamnesis study was conducted in 125 employees of EMERCOM of Russia suffered the mild craniocereberal trauma (MCCT). Duration of temporary disability of MCCT patients was (21 ± 6) days. Study object were 55 patients with the post-commotion syndrome lasting for 1 year. Besides clinical-neurologic investigation, the following parameters were assessed: dynamic indicators of MCCT scale for the acute period, scales of post-commotion symptoms, visual memory (Rey–Osterrieth test), the logic memory test and speech activity test, MFI-20 questionnaire, Spielberger–Khanin test, Hamilton anxiety rating scale. It turned out that the patients suffered from various disorders, including cognitive ones, which persisted for a year despite treatment; these disorders depended on specific social circumstances of a patient, and sometimes were supported by rental attitudes of patients.

Despite research carried out in the last few years, there is still no consensus on the need, feasibility and safety of endarterectomy in atherosclerotic lesions of the carotid bifurcation within 12–14 days after ischemic stroke. In the available literature there is no data on the possibility of this operation in patients with neurological deficit (Rankin scale score 4). The analysis of 110 carotid endarterectomies performed during the period from 2 to 14 days after the onset of ipsilateral cerebrovascular accident (CVA) has demonstrated the safety of the procedure (1 patient (0.9%) with postoperative CVA) and its effectiveness in preventing recurrent ischemic events. Despite the lack of advice about the possibility of performing carotid endarterectomy after CVA in patients with grade IV neurological deficit by the modified Rankin scale, we have proved the effectiveness and feasibility of this operation in this group of patients. No transformations of ischemic lesion into bleeding were observed. One patient developed a fatal CVA. During 12-month follow-up neurologic symptoms regressed in 16 (66.7%) out of 24 operated patients with grade IV neurological deficit by the Rankin scale.

Biochemical parameters of 24-hour urine from 235 military patients with urolithiasis were analyzed to determine the concentration and excretion of lithogenic substances, lithogenesis inhibitors and complexing agents. 24-hour urine pH and volume were assessed as well. Degrees of urine saturation with major lithogenic compounds were assessed, sequences of their deposition were identified as well as crystallization-initiating compounds. When urine pH increased (7.0 to 4.5), the saturation of urine with uric acid changed from values corresponding to unsaturated state (pH over 5.8) to critical supersaturation levels (pH less than 5.2). When pH decreased, urine saturation with phosphates increased more rapidly than urine saturation with uric acid under increased pH. Urine supersaturation with hydroxyapatite above the metastable zone is observed at pH greater than 6.1. The average pH for urine precipitation is (6.06 ± 0.89), whereas the average optimum pH value is (5.67 ± 0.19). Optimization of urine pH can reduce the risk of stones by 63 % (2.7 times) related to phosphate lithogenic compounds and uric acid. In 37 % of patients there is a risk of spontaneous nucleation of calcium oxalate, ammonium and sodium urates. An additional increase in urine output within the optimal pH range up to 1.8–2.0 liters of urine (1.4–1.5 times the original) virtually eliminates potential for nucleation of ammonium and sodium urates. After optimization of the urine acidity and an increase in diuresis, supersaturation with test compound higher than metastable level persists in 5.1 % of patients, including supersaturation with calcium oxalates, ammonium urates and sodium urates in 3.9 %, 0.8 % and 0.4 % of patients, respectively.

In recent years there has been an increase in the number of victims of road traffic accidents and emergencies that require the surgical treatment with reliable and safe anesthesia. The routine procedure with mechanically controlled concentration of inhalation anesthetic was compared with automated control of inhalation anesthetic and oxygen concentrations on the exhale (Et-control) during low-flow inhalation anesthesia (LFA). A prospective, randomized study included 80 patients who underwent surgery for the pathology of the spine and the spinal cord of varying severity, extent and localization. The study objective was to compare LFA course and sevoflurane consumption under mechanical and automated control of the anesthetic concentration in exhaled gas mixture during traumatic interventions on vertebra. The study showed that LFA with the automated control of exhaled anesthetic and oxygen concentrations 2 times lowers inhalation anesthetic consumption and considerably lowers the cost of anesthesia. This technique in high-risk operations, including neurosurgery, allows controlled anesthesia with optimal concentration of anesthetic and minimal hemodynamic response of the patient, while maintaining the quality of the general  anesthesia.

Pathogenetic and clinical features of acute carbon monoxide poisoning complicated with airway thermochemical lesions were identified; this requires significant correction of diagnosis and treatment approaches. It is shown that if the patient cannot be placed in a hyperbaric resuscitation chamber during mechanical ventilation, treatment strategy can be based on Acyzol antidotal effect. With the introduction of Acyzol in the treatment regimens, carboxyhemoglobin reduced more rapidly with marked positive dynamics in the course of endobronchitis, frequency and severity of respiratory, cardiovascular and nervous complications decreased, as well as coma duration. As a result, duration of mechanical ventilation considerably reduced along with mortality, duration of intensive care and total length of hospitalization.

3760 residents of St. Petersburg were examined in out-patient settings to assess the content of toxic chemical elements in hair samples. The work was carried out in the research laboratory for elemental analysis at the Federal State Institute of Public Health the Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia. Toxic elements (beryllium, aluminum, arsenic, strontium, silver, cadmium, cesium, barium, mercury, tallium, lead, lithium, nickel, and tin) were assessed in hair biosamples using quadrupole mass spectrometer with argon plasma (X-SERIES II ICP-MS). Screening identified risks of excess content of such metals as silver, aluminum, arsenic, cadmium, nickel and lead (hyperelementoses) in inhabitants of St. Petersburg.

The paper is focused on such manifestations of mass panic as increased intensity of emotions leading to overexcitation; feelings of danger and helplessness; uncritical perception of rumors. Results of studying panic manifestations in people exposed to a prolonged disaster (flood in Komsomolsk-on-Amure in 2013) are presented. Study sample included 223 subjects aged 17–56 (mean age 27.6 years). Behavior patterns were compared between conventional situations, retrospective evaluations at the time of flood and responses to information about potential flood in the near future. The study shows that the mass panic is most vividly manifested as increased emotions of prognosis (fear, fright and terror) and frustration (disappointment, despair and sorrow). The study results can help to diagnose rapidly panic manifestations in groups of people (including inhabitants of a city) during prolonged emergency situations.

Abstract. Firefighting activities are considered extreme and associated with a risk of acute or chronic loss of health, or even death. Procedure and objectives of compulsory state insurance of life and health in employees of the State Fire Service of EMERCOM of Russia are described. Regulations governing the provision of health care to personnel, as well as the mechanism of health care in this category of persons are considered. The most effective solution to the legal problem of providing free medical care to firefighters can be voluntary health insurance with employer as a policy holder or a special policy of compulsory health insurance to be issued to employees at hiring and returned back to the employer at retiring.

The main scientometric indicators are described along with the algorithm of searching articles in the database of the Scientific Electronic Library. For 10 years (2005–2014) 5701 scientific journal articles prepared by employees of the EMERCOM of Russia were indexed in the Russian Science Citation Index. Hirsch index of the array of articles was 17. On average, (570 ±110) articles were annually published. Polynomial trend with a high coefficient of determination (R2 = 0.99) shows a tendency to increase in the number of articles. 3508 articles (82.6%) were published in the journals on the list of Higher Attestation Committee of the Russian Education Ministry, 83 articles (1.5 %) – in the journals indexed in the leading databases, Web of Science Core Collection or Scopus. In 48 % of the articles issues of security and activities of the emergency services and fire protection were studied, 8 % of the articles were devoted to medicine and health, 7% – to the state and law, 6 % – to chemistry and chemical technology, 4 % – to public education. Half-life index of articles created by employees of EMERCOM of Russia (median citation chronology / citation) was about 5.5 years. There is low demand for articles of employees of EMERCOM of Russia. On average, 1 article was cited (0.93 ± 0.14) times. 27.6 % of the articles were cited at least once, i.e., only every third or fourth article was cited. Number of citations and number of cited articles tended to decrease. It is established that articles of the employees of EMERCOM of Russia were cited less frequently (p < 0,001) and the number of cited articles was lower (p < 0,001) compared with the authors from the St. Petersburg State University of Technology. During the study period, the Omsk State Technical University published 1,350 journal articles more than EMERCOM of Russia. These universities published 12.3 and 6.9 times as many articles as EMERCOM of Russia in journals indexed in the Web of Science Core Collection or Scopus. EMERCOM of Russia has a high scientific and pedagogical capabilities. A more in-depth study is required. Ways to increase scientific value of articles and their integration into international databases are shown.

Index of articles Journal Mediko-biologicheskie i sotsial’no-psikhologicheskie problemy bezopasnosti v chrezvychaynykh situatsiyakh [Medico-Biological and Socio-Psychological Problems of Safety in Emergency Situations]. 2015 N 1–4