Relevance. Patients with fractures of long tubular bones and the pelvis represent the largest group of the injured or affected in need of reliable transport immobilization. Conventional devices for transport immobilization do not provide rigid fixation, especially for fractures of long tubular bones of lower extremities. Immobilization of unstable pelvic injuries at the prehospital stage poses challenges due to the lack of a regular immobilizing device.
Objective. Propose a new method of transport immobilization using a multifunctional evacuation-transport immobilizing device (METID).
Methods. Rates of transport immobilization, as well as advantages and disadvantages of the existing transport devices have been analyzed. The experience with METID in medical military formations was studied.
Results and Discussion. The set of constructive solutions implemented in this device significantly increases reliability and safety of immobilization for monitoring vital functions of victims and providing respiratory and infusion support. The device can be placed in mobile medical complexes equipped with transport-sanitary sets using the standard on-board network and external sources of oxygen.
Conclusion. METID device proposed for transport immobilization and transportation of the wounded and injured can be actively used in units the Russian Defense Ministry and the Emercom for medical assistance.

Relevance. Many Chernobyl accident liquidators suffer from cognitive disorders, possibly due to encephalopathy-related organic damage of the brain. Diffusion Tensor Magnetic Resonance Imaging (DT-MRI) quantitatively assesses white matter of the brain. Detection of changes in the brain structures that are responsible for cognitive functions is critical for understanding their involvement in the degenerative processes as well as for vascular dementia prognosis.
Intention. To establish correlation between DT-MRI results and neuropsychological findings in Chernobyl accident liquidators (study group: 58 patients, 36 with and 22 without cognitive disorders) and a control group of 43 patients without exposure to radiation or Chernobyl accident-related factors – 16 with and 27 without cognitive disorders. Patients in both groups were of similar age.
Results and Discussion. Comparing patients with cognitive disorders from the two groups, significantly (p < 0.001) decreased Fractional Anisotropy (FA) coefficient was identified for the temporal lobe and internal capsule in the study group.
Comparing patients without cognitive disorders from the two groups, significantly (p < 0,05) decreased FA coefficient was identified for the brain frontal lobe, temporal lobe and internal capsule. This can be explained by sensitivity of the above brain structures to Chernobyl accident factors and their effects.
Conclusion. White matter damage detected in Chernobyl accident liquidators was similar to that in older people with cerebral vascular pathology.

Relevance. The scientific research conducted in the field of medical support at elimination of medical and sanitary consequences of the emergency situations (ES) is inseparably linked with process of modeling of complex systems. Modeling is a study of objects, processes and the phenomena for definition (specification) of the studied characteristics of the surveyed system or specification (improvement) of the offered new elements of this system. Simulation modeling is one option to study medical support system experimentally.
Intention. Simulation modeling is necessary for developing respective models of special purpose medical group functioning, describing the main components of health care delivery to the wounded at ES taking into account their medical and evacuation characteristics.
Methodology. For experiments, discrete and event simulation models were used which represented the system under study, its states changing with specific events in discrete time points. During research, the behavior of separate elements of the modelled system (a special purpose medical group) is described via Python programming algorithms and using the SimPy library. The following data were used as model parameters: victim in-flow structure with time-frames of various medical procedures and manipulations / surgeries as well as time-frames of non-transportability of victims with various lesions. For model simplification, in-flows of victims with penetrating and non-penetrating wounds of various severity were simulated.
For modeling, averaged in-flow structures by severity grade in various ESs were used: 29.1 % – mild, 27.2 % – moderate, 42.1 % – severe and 1.6 % – extremely severe. Time-frames of medical manipulations and procedures, time-frames of nontransportability were described as random variables with triangular distribution (Simpson); its parameters were estimated by military-medical experts (surgeons, therapists). A simple Poisson process with various parameters was used for modeling the victim in-flow. During modeling, group work was assessed with victim in-flow of 40, 60, 80, 100 persons a day.
Results and Discussion. Results of modeling indicated some potential bottlenecks of a special purpose medical group, i.e. surgical unit and intensive care unit. It was shown, for example, increased number of surgical teams can enlarge considerably the capacity of a special purpose surgical unit and medical group in general, but at the same time will demand augmentation of capacity of the intensive care unit due to increased flow of the postoperative wounded. Possible effects of such advanced technologies as Celox GauzeR bandage and maintaining wounds with low pressure bandages were studied (vacuum assistant closure – VAC, negative pressure wound therapy – NPWT). Preliminary conclusions were made on appreciable effectiveness of the specified technologies in work of a special purpose medical group.
Conclusion. Simulation modeling is one of the most popular types of mathematical modeling and is used for research of complex systems. Therefore, it can be successfully used when modeling work of a special purpose medical group at elimination of medical and sanitary consequences of ESs. The developed simulation model helps analyze the changing workload of the group with various in-flows of wounded as a result of natural, technogenic and social ESs.

Relevance.The harsh climate and remoteness of settlements make it difficult to provide emergency medical care to victims with a shockogenic injury in the regions of the Arctic zone of Russia.
Intention. To analyze the medical and social characteristics of victims with a shock injury admitted to all the medical organizations of the Arkhangelsk region in 2002 and in 2008–2013, after organization of a first level trauma center at the Arkhangelsk Regional Clinical Hospital.
Methodology. Medical documents from 140 victims with shock injuries aged 18 years and older (2008–2013, Group 1) and 104 victims (2002, Group 2) were analyzed. Source documents: work sheets for examining victims with a shock injury, inpatient medical records (Form No. 007/y), accompanying coupons from the ambulance (Form No. 114 / y).
Results and Discussion. Road traffic injuries dominated among the shockogenic injuries in both groups. More than 30 % of road traffic injuries occurred on the federal motorway M-8 within 250 km from the city of Arkhangelsk. The greatest share of injuries occurred after 4 p.m, on Saturdays and Sundays and in winter in both groups. Among all the shock injuries, combined injuries comprised 51.8 %, 67.9 %, isolated ones – 38.4 and 21.4 %, multiple ones – 9.8 and 10.7 % in groups 1 and 2, respectively. There is an increase in the number of victims aged 20–29 years (p = .012) compared to 2002. The share of victims with alcoholic intoxication has practically not changed. About 1/3 of the injured had alcoholic intoxication.
Conclusion. Since e most shockogenic injuries occur in winter under the severe Arctic climate, additional means should be provided for supporting life of the victims (heating, small-volume infusions, etc.). The analysis revealed the need for a single algorithm for diagnosis and treatment of victims with a shockogenic injury in the Arkhangelsk region.

Relevance. In 2010 in the Armed Forces of the Russian Federation on the basis of one military unit as an experiment, a trial of a new type of military servicemen physical training (PhTr) was started. The new type of PhTr was supposed to double the time for PhTr from 12 to 25 hours a week. This daily 4-hours PhTr with increased loads turned out to be extreme for servicemen.
As a result of this strenuous training, the increase of servicemen morbidity was noticed that could lead to decline in combat capability of military units.
Intention. The aim of the present study was to evaluate from the epidemiological point of view the servicemen morbidity under conditions of extreme PhTr.
Methods. To analyze the trends of morbidity rate and structure, hospitalization rates were used. Hospitalization rates were analyzed retrospectively from 2007 to 2013 for conscripts engaged in the trial of the new PhTr model. The control group consisted of conscripts with similar activities and every day life; the only difference was absence of new PhTr.
Results and Discussion. Two-fold increase in PhTr volume along with intermixing and low fitness of conscripts resulted in statistically significant increase (99.9 % confidence) in general hospitalization rates (by 12.0–12.9 % and 100.5–108.6 ‰); hospitalization rates for acute respiratory diseases (blocks 1.1–1.3 chapter X ICD-10; 27.9–34.9 % and 145.5–182.6 ‰); acute respiratory diseases among all admitted increased by 10.6–12.1 %; acute bronchitis with bronchiolitis (J20–J21 ICD-10) by 217.1 % and 128.5 ‰, community acquired pneumonia (J12–J18) by 74.8 % and 37.2 ‰, respectively; unspecified acute lower respiratory infection (J22) by 201.8 % and 7,2 ‰, respectively. Cumulative days of absence from work due to the above mentioned nosologies increased by 2488.4 ‰ (or 2.9 times).
Conclusion. Nowadays, for adequate combat capability, it is necessary to intensify PhTr; however, morbidity should not exceed sporadic levels. Hence, it is essential to create appropriate conditions and organize suitable activities in order to restrict the influence of negative factors and, thus preventing diseases among servicemen.

Introduction. Viral hepatitis contact transmission in medical organizations is a potential threat to medical personnel while carrying out their professional activity.
The aim of the research. To study the prevalence of viral hepatitis among staff in in-patient settings in St. Petersburg takind into account hepatitis B vaccination coverage and frequency of blood-contact injuries.
Materials and methods. The study used data from 62 hospitals in St. Petersburg for the period from 2009 to 2016.
Results. Viral hepatitis B and C detection rates among medical staff in hospitals of St. Petersburg are provided. Main risks factors of contamination for health care professionals of various specialties are presented. Hepatitis B vaccination coverage in medical organizations has been analyzed.
Conclusions. High risk of viral hepatitis in medical staff results from frequent admission of patients with acute or chronic viral hepatitis to hospitals in St. Petersburg, a small infecting dose, the lack of specific prophylaxis against hepatitis C, potential injuries in the process of examination and treatment.

Relevance. High incidence of circulatory diseases in Chernobyl accident recovery workers (ChARW) is closely connected to hemostasis pathology. The introduction of new “global tests” (as they are called) which assess plasma hemostasis state brings about the additional opportunities for diagnostics of hypercoagulability syndrome (HS) as a risk factor of thrombotic complications at circulatory diseases.
Intention. The objective of the work is to study the state of plasma hemostasis system in ChARW with circulatory diseases using method of thrombodynamics (TD).
Methods. 140 male ChARW, aged 44 to 82, diagnosed with discirculatory encephalopathy, ischemic heart disease, essential hypertension were examined. All patients underwent complex clinical, instrumental and laboratory studies. TD test (TD recorder, by HemaCore, Russia) showed the lag-time for the beginning of clot formation (Tlag, min.), rate of clot growth (V, um/min.), spontaneous clots formation time (Tsp, min.) and some other additional parameters: initial rate of clot growth (Vi, um/min.), fibrin clot size (CS, um)and its density (D, a.u.).
Results and discussion. The obtained results demonstrate HS formation in ChARW with circulatory diseases. This group of patients is characterized with considerable increase of fibrin clot growth rate (V) and spontaneous clots formation within the measuring area at distance of clot activator (Tsp), i.e. the increase of those TD test parameters which are more sensitive to microvesicles formed at thrombocytes activation. TD tests parameters have been related to the applied antiaggregant therapy, brachiocephalic artery atherosclerosis and diabetes mellitus.
Conclusion. TD method improves considerably the opportunities of the laboratory diagnostics in HS detection in patients with circulatory diseases.

Relevance. Radiation injuries with the variety of clinical forms occupy an important place in a military therapeutic pathology. Acute radiation sickness (ARS) is the result of the biological effects of the ionizing radiation on a body. Currently, there are ongoing studies in the area of radiobiology and radiological pharmacology, with the main purpose to assess safety, pharmacodynamics and mechanisms of the new radioprotective drugs. However, for successful study of their pharmacological activity in the model of ARS (mice) it is necessary to clarify mechanisms of acute radiation injury and also identify optimal radiation doses for studying specific parameters.
Intention. Development of a model of acute radiation bone marrow syndrome in the experiment on mice irradiated in the dose range of 3–9 Gy.
Methods. The experiments were carried out in animal model (350 male mice). Life expectancy, the dynamics of body weight, the basic hematological parameters and functional states (Tail Flick, Grip Strength System, Retention on a Horizontal Grid, Rotarod and Light-dark test), 30-day survival were studied post-exposure (3-9 Gy).
Results and Discussion. The obtained results indicate that the body weight dynamics, survival, life expectancy, severity of leukocytopenia and thrombocytopenia, and also changes in the total functional status of the animals in acute radiation injury (3–9 Gy) are dose-dependent. Besides, the obtained data substantiate a differentiated approach to the choice of irradiation doses and terms of registration of parameters when studying potentially promising radioprotective drugs.
Conclusion. For research of effective application of physiologically active substances in the experimental model of acute radiation injury in mice it is advisable to use the following radiation doses: 5 Gy – to evaluate hemostimulating activity of therapeutic agents with registration of indicators on days 3–28 after exposure, 6.5 Gy – to assess survival and life expectancy over 30 days; 8 Gy – to study functional state of animals (4 days in the Light-Dark Test, 4, 7 and 10 days in Retention on a Horizontal Grid).

Relevance. Representations of emergency in employees of EMERCOM of Russia play an important role in the control of behavior, comprehension of reality and environment of professional activity adaptation. The research of representations of emergency in employees of EMERCOM of Russia will allow defining the approaches to formation of the most complete adequate understanding of emergency situations in future professionals of an extreme profile.
Intention. The research objective is to define specifics of structure and content of representations of emergency in staff of EMERCOM of Russia with different experience of rescue work.
Methodology. Representations of emergency were analyzed in cadets, firefighters and rescuers. Frequencies of concepts in descriptions of emergency situations were assessed using an author’s test “20 definitions of emergency”, the method of content analysis and expert assessment.
Results and Discussion. Differences were identified in the frequency of positive, neutral and negative evaluations of emergencies from Russian Emercom employees with different experience in dealing with disasters. Differences in the structure of representations of emergency situation have various levels of differentiation and integration relations of the elements in the structure. The image of emergency situation reflects not only objective characteristics, but also the subjective importance of emergency situation for the expert.
Conclusion. The obtained results should be considered when developing programs of psychological preparation for actions in emergencies and psychological support of the post-expedition period.

Relevance. Necessity of developing a system of prevention of road traffic injuries and increasing effectiveness of measures to prevent road traffic injuries in road users.
Intention. The analysis of the theoretical and empirical results of the study of clinical and psychological factors of high-risk behavior to ensure road safety.
Methods. The search for materials from foreign theoretical and empirical studies has made it possible to systematize data on theoretical and methodological approaches to the study of high-risk behavior of road users, as well as the impact of various clinical and psychological aspects of road users on the safety of behavior.
Results and Discussion. Summarizing the data, the following factors for successful and safe driver’s actions were determined: operational qualities (i.e. the ability to quickly, accurately and correctly perceive and process all incoming information, develop an adequate solution in a timely manner and perform the necessary response actions); driver’s emotional stability and volitional qualities. The factors of pedestrian traffic safety include: the ability to adequately assess the safety of their own road behavior, compliance with traffic rules.
Conclusion. In order to ensure road safety, it is desirable to assess subjective models of the traffic situation in drivers and pedestrians, to analyze risk factors for victim behavior in road users and develop modules of interagency cooperation to ensure road safety and facilitate programs for prevention of road traffic injuries.

Relevance. The growing number of manmade and natural emergencies and disasters in the world along with terrorist threats make it necessary to improve and integrate the scientific, educational and clinical aspects of rendering medical care to the victims.
Intention. To analyze the activities of international organizations in the field of disaster medicine.
Methods. Activities of the World Association for Disaster and Emergency Medicine (WADEM) and the Association for Disaster Medicine and Public Health (SDMPH) were analyzed. Publication indicators of scientific journals Prehospital and Disaster Medicine (WADEM) and Disaster Medicine and Public Health Preparedness (SDMPH) are presented. The journals are indexed in the Scopus database and the Web of Science Core Collection.
Results and Discussion. The tendency of increasing the publication activity of journals has been revealed. The average annual array in 2012–2016 was (140 ±19) and (122 ±17) articles; respectively. According to the Scimago Journal & Country Rank (http://scimagojr.com), these journals have high scientometric indicators. On average, for Prehospital and Disaster Medicine and Disaster Medicine and Public Health Preparedness, each article was quoted 4.94 and 4.7 times, and at least once 62.4 % and 63.6 % of the array of articles were quoted respectively. Scientometric indicators of the authors who published the largest number of articles on disaster medicine in 2007–2016 were analyzed.
Conclusion. The analyzed articles written by leading authors in the field of disaster medicine open up great information opportunities for scientists and practitioners.