Suicidal burns pose a serious social and medical problems for the society. A review of literature on self-immolation for 2001-2013 is presented. Intentional burns are accounted for 2-9 % of admissions to the burn departments in Europe andNorth Americaand 25 % - in developing countries. Both low level of living and education influence patterns of these burns, their severity and consequences. The mentioned features allow combustiologists and related physicians to provide an adequate care for these severe and unusual victims.

Among the objectives of minimizing the effects of radiation emergencies, health interventions are of key importance. Development of a system of regional emergency medical response significantly increases the efficiency of decision-making and implementation of practical measures in accordance with an actual situation. There are presented functional purpose and capabilities of Northwest Regional Emergency Medical andDosimetricCenterthat is part of the Federal Medical-Biological Agency of Russia and was formed in 2010; conditions of its activity and objectives of integration into the health care to victims of radiation accidents are also described.

The results of statistical studies of disease incidence, injuries and death of the personnel of the Ministry of Emergency Situations of Russia for 2010-2012 are presented. Most cases and days of temporary disability are related to respiratory diseases (1st place), trauma (2nd place) and diseases of the musculoskeletal system and connective tissue (3rd place). The analysis can be the basis for improving working conditions in the Russian Emergency Situations Ministry units.

446 patients with diseases of the peripheral nervous system accompanied with chronic pain syndrome were examined and treated. Pain syndrome in diseases of the peripheral nervous system, lasting more than 3 months, becomes chronic. Not only peripheral but central nervous system becomes involved in the pathological process. Along with neuropathic pain, severe autonomic, emotional disorders, a high level of state and trait anxiety is reported, with high level of fatigue and, to a lesser extent, depressive disorders. Severity and frequency of anxiety disorders reduces, as opposed to depressive ones, with longer duration of a disease. Affective and asthenic disorders affect the nature and intensity of pain, significantly worsens the prognosis of the disease. Targeted treatment of psychophysiological disorders helps to stop chronic pain and prevent disability more efficiently.

Since opening of Transfusiology Department in theA.M.NikiforovRussianCenterof Emergency and Radiation Medicine, EMERCOM of Russia, harvesting of blood components has been performed using leukoreduction, plasma quarantine and inactivation of viruses in platelets. During 3 quarters of 2012, 411 doses of red cell-containing media were harvested as compared to 809 doses over the same period in 2013; besides, erythrocyte mass harvesting was discontinued completely in favor of the following higher-quality components: red cells depleted of leukocytes and platelets, erythrocyte suspension without leukocyte and platelet layers in SAGM additive solution and cryopreserved erythrocytes. To provide hemostasis in patients with bleedings, harvesting of fresh frozen plasma (FFP) (770 doses) and platelets (40 doses) was increased in 2013 compared to 2012 (401 and 10 doses, respectively). In 2013, apheresis was more widely used for obtaining platelets and FFP (417 and 99 doses, respectively) compared to 2012 (217 and 22 doses). In order to increase the percentage of FFP to be released for clinical use after quarantining, a permanent contingent of plasma donors is advisable.

A comprehensive study of the impact of blood donations on hematology was performed in donors from the Arctic region. It was established that harvesting (420 ± 10) ml of blood from donors working in adverse ecological and occupational conditions and exposed to ionizing radiation in doses not exceeding the maximum permissible level, did not cause changes in cell structure, biochemical and immunological parameters of peripheral blood beyond reference values. Peripheral blood parameters in donors recover within 28 days after the donations to the initial values.

The problem of transport accidents has been actual for a long period of time. According to SRTSI (State Road Traffic Safety Inspection) data for 12 months of 2012, 3917 traffic accidents were registered on theterritoryofVoronezhregion, in which 614 people died and 4714 people were injured. During 2012, there were also registered 387 traffic accidents with children, in which 17 children under 16 years died and 411 got traumas. On theVoronezhregion territory, four Level 1 traumatologic centres provide specialized medical care; 9 Level 2 centres and 24 Level 3 centres which are central district hospitals. According to the results of FRIHOI of MoH of the RF study, in 2008 the time period from receiving the call by an ambulance department till emergency team arrival at the place of RTA in 9 % of cases was 30 minutes but no less than 21 minutes. In 3 % of cases, this time period was reported to exceed 50 minutes. According to the analysis, time period from transportation beginning till admission to the medical facility was 21-30 minutes in 10 % of cases. In 4 % of cases, it was reported to be more than 40 minutes. Medical care commonly starts in more than 60 minutes in case of transportation from federal roads outside populated areas. Conducted studies show that health outcomes in RTA victims can be improved via adjustment of medical facilities responsibility zones depending on their facilities, staffing, mode of operation, as well as nature of traumas.

The analysis of hemodynamic and homeostasis parameters has been performed in employees of search and rescue teams (SRT) of Emercom of Russia who suffer from metabolic syndrome. Multidirectional changes of biochemistry parameters and hormone concentrations in blood serum have been revealed in SRT employees compared to control group of civil patients. Metabolic syndrome in SRT employees is related to increased hydrocortisone concentration compared to civil patients. SRT employees are characterized by higher blood pressure and lower BMI compared to patients from the control group. In SRT employees with metabolic syndrome, metabolic disorders with prevailing catabolic reactions and altered plasma lipid spectrum are observed based on statistically significantly lower cholesterol and high-density lipoproteins and higher triglycerides compared to those of control group. Biliary tract motor disorders and dyscholia associated with the metabolic syndrome are typical for SRT employees.

The study included 92 patients with hemodynamically significant stenosis of the internal carotid artery, which were divided into 2 groups: 1st - with sufficient structural and functional potential for compensation of cerebral blood flow, 2nd - low structural and functional potential for compensation of cerebral blood flow. Retrospective immunoenzyme method of semiquantitative determination of antibodies to NR2A subunit of NMDA glutamate receptors was used. It was found that in group 2 patients alteration of NMDA glutamate receptors prevailed. Deterioration of cerebral blood flow for a period ofICAclamping during surgery is a factor objectively aggravating hypoxia in the affected vascular region and enhancing the degree of alteration of NMDA glutamate receptors. At the same time, the longer theICAclamping, the higher the degree of destructive effects on NMDA glutamate receptors through mechanisms of excitotoxicity.

The aim of the study was to demonstrate the practical use of «global» laboratory test - low- frequency piezothromboelastography in assessing and monitoring hemostatic disorders in critical conditions (hemorrhagic shock, posttraumatic thrombosis and hemorrhagic complications). Technology of low-frequency piezothromboelastography in «point - of - care test» mode provides information on all three phases of coagulation with an integrative assessment of the state of vascular-platelet, coagulation, anticoagulant components of hemostasis and total fibrinolytic activity. It is shown that the evaluation of hemostatic potential of whole blood - the integrative activity of vascular-platelet, coagulation, fibrinolytic and anticoagulant hemostasis defining actual rheological properties of blood and its ability to limit extravasation of cellular and liquid components when vascular wall is damaged using low-frequency piezothromboelastography makes it possible to reveal critical hemostatic disorders and develop adequate approach for their correction

Abstract. An acute 4-hour hypokinetic stress was experimentally shown to induce qualitatively identical changes in the liver functional state and metabolic activity in rats with high or low resistance to hypoxia. This manifested in hypotension, bradycardia, decreased rectal temperature, respiration rate and oxygen intake as well as in disordered acid-alkaline balance with lactic acidosis signs. The rats demonstrated excretory, antitoxic and enzyme liver dysfunctions, with reduced energy potential. The degree of changes in the low-resistant rats was higher than in high-resistant animals.

 

Application of wound dressings with bioactive nano-complex - fullerenol and silver-modified montmorillonite at prehospital stage is justified in the settings of natural and man-made disasters, local armed conflicts, accompanied by the appearance of burns, severe mechanical trauma, gunshot bullet and mine blast wounds

Experimental models of radiation oropharyngeal syndrome were developed for both isolated (radiation) and combined (radiation, chemical and herpes virus) exposure of laboratory animals. Preliminary infecting the tested animals with herpes simplex type 1 virus (HVS-1) before chemical and radiation exposure increased radiation lesions in mucous membrane of the oral cavity in rats, thus aggravating oral mucositis with about 40 % death rate. When Molixan, possessing immunomodulating and antivirus properties, was used for treatment and prevention, radiation oropharyngeal syndrome incidence decreased by 2-3 times, along with symptom severity, thus enabling all the tested animals to survive.

Effectiveness of preparations of actoprotectors class prescribed to correct adaptation processes in cardiovascular and central nervous systems was assessed in miners of Kumtor high-mountain mine working on a rotational basis. 58 miners (male drillers and miners aged 19-45 years) working constantly at the main production site took part in this randomized controlled trial. They were divided into three groups. The first group of 25 men took placebo, the second group of 15 men took metaprote at a dose of0,125 g(preparation with adaptogenic action from mercaptobenzimidazole class, Pharmproject Closed Corporation, St. Petersburg), and the third group of 18 men took metaprote at a dose of0,25 gtogether with ladasten at a dose of0,100 g(antiasthenic remedy, adamantane derivative, Lekko Pharmaceutical Firm, Vladimirskaya obl., Petushinski region, Volginski settlement). Drugs were administered three times per shift on Day 2, 7 and 13 one hour before examination. It is established that study drugs facilitate adaptation of cardiovascular and central nervous systems. In «placebo» group, no complete adaptation of cardiovascular and central nervous systems is observed at the end of the second week of shift. Metaprote accelerates the adaptation of cardiovascular system, but psychophysiological state is characterized by decreased vigilance level. The combined intake of metaprote with ladasten provides optimal functional state of cardiovascular system already on shift day 1 and psychophysiological state at the end of shift week 1.

Psychological state of 23 medical psychologists who are members rescue teams and provide psychological aid in accidents and disasters is described. Control group comprised 32 medical (clinical) psychologists of the same age who work at health institutions but have no experience of rescue and other emergency activities. It is shown that after a sufficiently long time since emergencies medical psychologists develop symptoms and signs of the post-traumatic stress syndrome. Professionally important qualities are identified that define a successful career of medical psychologists in extreme conditions. A number of measures are proposed to preserve mental health and career longevity in medical psychologists who are members of the rescue teams and participate in rescue and other operations in emergency situations.

The author's concept, structural and functional transformational model of psychological safety of personality of specialist of extreme activities consists of four-factor structure of psychological safety of personality under normal conditions of life (morality-communication, motivation-will, value-meaning, internal comfort) and four-factor structure of psychological safety in extreme settings (morality-will settlement (normativeness), strategies of coping with stressful situations, value-meaning, post-traumatic growth / regression). Psychological mechanisms of genesis of system of the psychological safety of personality have been described.

Electronic catalogs of the Russian State Library (Moscow), National Library of Russia (St. Petersburg) and the Central Scientific Medical Library (Moscow) were the object of research. The search generated an array of 423 dissertations on specialty 14.03.10 (14.00.46) «Clinical Laboratory Diagnostics» submitted to the dissertation councils inRussiain 1996-2012. Polynomial trend of dissertation quantity with a high coefficient of determination (R2 = 0.89) resembles a shallow inverted U-curve with the maximum in 2007-2009. Annually inRussia, an average number of dissertations submitted to dissertation councils was (25 ± 4), including doctoral (5 ± 1) and candidate (20 ± 3) dissertations. Doctoral theses comprised 17.7 %, candidate theses - 82,3 %. There is a relative stabilization of the number of doctoral and candidate dissertations. Medical dissertations comprised 85,8 %, biological ones - 14,2 %. Increasing share of medical dissertations has been revealed. Among dissertations, 29,6 % were devoted to foundations of the theory of clinical laboratory diagnosis, 22,8 % - to chemical studies of biological fluids, 6,5 % - to morphological (cytological) research of biomaterial, 16,3 % - to immunological studies, 7,9 % - to microbiological studies, 3.8 % - to cytogenetic and molecular genetic methods, 10,5 % - to improvement of methods of laboratory diagnosis, and 2.6 % of dissertations were devoted to the basics of organizational support of laboratory diagnostics.