Relevance. In emergency settings, medical care for thermal burn injuries remains a crucial problem of disaster medicine. In industrially advanced countries with ongoing urbanization, burns represent a most frequent and severe type of injuries requiring emergency medical care. The study objective is to analyze the efficiency of emergency medical care provided in Moscow over the 6 year’s timespan (2018 to 2023) to victims of emergency accidents presented with thermal burns.

Methodology and methods. The study relies on the data obtained from the Disaster Medicine of Moscow automated analytical information system with a focus on the victims of emergency accidents presented with burns throughout the past 6 years (2018 to 2023). The platform is managed by the Moscow Territorial Scientific and Practical Center for Disaster Medicine (CEMP) and the N.V. Sklifosovsky Research Institute of Emergency Medicine.

Results and discussion. Over the past 6 years (2018 to 2023), the emergency accidends affected 1989 victims presented with thermal burns, including 438 (22.0 %) declared dead at the scene prior to the arrival of CEMP medical and specialized emergency response teams. 1,216 patients (61.1 %) were evacuated to referral centers at multidisciplinary hospitals, 315 patients (15.9 %) travelled to medical hospitals by passing-by vehicles to apply for medical help independently, and 20patients (1 %) were referred for outpatient follow-up. Overall, 597 patients were admitted to burn injury department at the N.V.Sklifosovsky Research Institute. Those included 33.1 % in extremely severe and severe condition, with 1.7 % requiring tracheal intubation and respiratory ventilation support.

Conclusion. At pre-hospital stage, deployment of the medivac ICU teams is the most promising strategy to ensure high quality medical care. Given the high incidence of multiple injuries (up to 49.6 %) in emergency accidents, sophisticated medical care shall be provided by a multidisciplinary team of reconstructive burn surgeons, ICU staff specializing in inhalation injuries, and medical professionals.

Relevance. Motor vehicles are a highly traumatic type of transportation and the cause of traffic accidents with medical consequences, including large numbers of severe shock-associated injuries. Federal, regional and local highways differ significantly by the type and quality of pavement, technical maintenance and upkeep, which affects the safety conditions for drivers and pedestrians.

The objective is to analyze shock-producing injuries in victims of road accidents on federal, regional and local roads in the Arctic zone of the Arkhangelsk region to characterize the incidence, type and severity of traumatic injuries.

Methodology. A set of criteria for case series description was used to analyze medical records of 72 victims presented with shock-producing injuries as a result of road accidents on federal, regional and local roads of the Arkhangelsk region who were admitted to a level 1 trauma center of the Arkhangelsk Regional Clinical Hospital. The injury type was characterized according to A.V. Kaplan et al. classification. We identified the following types of injuries: isolated (single lesion), multiple (several foci in a single body area), and combined (several foci in different body areas) injuries. Combined injuries were split in 3 categories according to the criteria developed by E.K. Gumanenko et al.: severe combined injuries, multiple injuries, and extremely severe multiple injuries. The injury severity was assessed by the Injury Severity Score. The STATA version 12 software was used for statistical analysis of the results.

Results and discussion. In the Arkhangelsk region, 70 % of the road accidents resulting in shock-causing injuries occurred on the M-8 ‘Kholmogory’ federal highway. These accidents are largely represented by car-to-car collisions (65 %), where regional and local roads are typically characterized by car collisions with pedestrians (52 %). In case of the federal highway accidents, the overwhelming majority of victims with shock-causing injuries have combined injuries (90 %); this rate decreases to 65 % (p < 0.001) for regional and local roads. On the M-8 ‘Kholmogory’ federal highway, accidents are show a 1.4 times higher risk of the most severe mechanical injuries – multiple injuries – than accidents occurring on regional and local roads. Thus, in the Arkhangelsk region, medical treatment organizations require stronger workforce and logistics support; mobile highway safety points should be set-up along the M-8 ‘Kholmogory’ federal highway to ensure prompt emergency medicacare, both on federal and regional or local roads.

 Conclusion. By incorporating the public status of a road into the analysis of occurrence, type and severity of shock injuries in victims of road accidents in the Arkhangelsk region, we were able to substantiate proposals to pursue reduction in the injury rates. The M-8 ‘Kholmogory’ federal road requires drivers to unconditionally observe and comply with traffic rules regarding over taking and speeding through extensive deployment of both stationary and portable video recording devices, as well as quadcopters. As for regional and local roads, special attention should be granted to pedestrians’ behavior, such as walking along the hard shoulders of highways, crossing the road at night time, as well as impaired visibility conditions. Intoxicated pedestrians constitute a very specific category. The basics of safe behavior on roads and highways should be nurtured in the preschool and school age.

The objective is to analyze morbidity dynamics among the military of the Russian Armed Forces within a 19 years’ timespan from 2003 to 2021 (at peacetime).

Methods. We studied the morbidity rates of among the military based on the database of medical reports (3/MED form) and open-access publications. Medical and statistical indicators for the main chapters of diseases were correlated with the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10). Morbidity was calculated in ppm (%) and mortality – per 100,000 people (10–5). The paper reports long-term averages calculated based on absolute data, arithmetic mean values and standard errors (M ± m). The dynamics was assessed by analyzing the dynamic time series and the 2nd order polynomial trend Pearson’s correlation coefficient was used to calculate the congruence between trends.

Results and discussion. From 2003 through 2021, the average long-term general morbidity (turnover) among all the military of the Armed Forces of Russia amounted to 1270.9%; primary morbidity – 687.7%; screening demand – 113.2%, hospital admissions – 513%; days off work – 6727%; dismissals – 11.8%; mortality – 80.4 ± 10–5. Trends in general morbidity, demand for screening, and mortality rates show a decreasing pattern; primary morbidity, hospital admissions, and days off work show inverted U-curves with the highest values from 2009 through 2013. The epidemiological assessment demonstrated that the 71.4% morbidity among the military of the Armed Forces of Russia included diseases of the respiratory system (Chapter X) – 24.2%; injury, poisoning and certain other consequences of external causes (Chapter XIX) – 20,3%; diseases of the circulatory system (Chapter IX) – 11.4%; diseases of the digestive system (Chapter XI) – 7.8%; mental and behavioural disorders (Chapter V) – 7.7%, respectively.

Conclusion. Prompt diagnosis, treatment, rehabilitation, and prevention of the above groups of diseases can significantly improve the health among the military of the Russian Armed Forces.

Relevance. In Russia, emergency protection efforts by various ministries are guided by the relevant legal regulation based on the Integral National System for Emergency Prevention and Elimination. Its functionality relies on joint cross-departmental capacities to ensure national protection of the population and land from emergencies. Medical capacities are not an exception in this respect. The Medical Service of the Russian Armed Forces manages substantial resources to fulfill this goal. The Disaster Medicine Service of the Russian Defense Ministry was therefore established both as functional subunit of the Russian Armed Forces for emergency prevention and elimination and a critical link within the Russian National Disaster Medicine Service. To maintain the required level of preparedness, further studies regarding the performance of medical units within the Disaster Medicine Service is critically required.

The study objective is to investigate the professional capacities among the military medical and civilian professionals employed by central and regional military medical organizations of the Defense Ministry, who are also non-staff members of the Disaster Medicine Service; to identify practical challenges in performing duties and assess the overall preparedness.

Methods. This study is based on a survey among military medical and civilian professionals employed by central (n = 81) and regional (n = 146) military medical organizations of the Defense Ministry who are also non-staff members of the Disaster Medicine Service. The survey obtained data regarding the responders’ professional status, duties within non-staff teams, and demographic parameters. Mean and median values, including with upper and lower quartile are reported in the paper.

Results and analysis. The study results show that the average age of among medical professionals among non-staff teams of central military medical organizations of the Russian Defense Ministry is 38.8 [6; 17] years and 38.2 [7; 14] years for those employed by regional medical organizations. In central military medical organizations, most medical teams are represented by therapists (25.9 %), followed by thoracic and abdominal surgery (17.3 %), and general surgery (13.6 %); whereas at the regional level teams comprising doctors and nurses prevail (54.8 %), followed by intensivists and general surgeons (9.6 % each), and therapists (8.2 %). Non-staff units of the Disaster Medicine Service of the Defense Ministry, operating within central military medical organizations include more subspecialty teams; on the contrary, regional non-staff units have broad and general specialties. Notably, military medical and civilian professionals employed by central military medical organizations provided emergency primary health care in 61.7 % of cases, whereas specialized medical care, including high-tech medical care was provided in 34.6 % of cases. Military medical and civilian professionals employed by regional military medical organizations provided emergency primary health care in 37.7 % of cases, and specialized medical care, including high-tech medical care in11.6 % of cases. The survey confirmed that while performing their duties, military medical and civilian professionals who were members of the non-staff teams were challenged by the following most significant factors: the level of specialized training, number and quality of staff in the teams, as well as compliance with the regulatory and legal requirements to medical activities performed within the efforts to eliminate medical and sanitary consequences of emergencies. This data allowed to develop relevant parameters and measurements to assess preparedness among the non-staff teams to perform their duties

Conclusion. Professional capacities among the military medical and civilian professionals employed by central and regional military medical organizations of the Defense Ministry, who are also non-staff members of the Disaster Medicine Service was investigated, with the most significant challenges affecting their performance identified. Preparedness was assessed among the non-staff teams of the Disaster Medicine Service of the Russian Defense Ministry in central and regional military medical organizations.

Relevance. Proximal humerus fractures constitute 5 to 6% of all fractures in adults and are the third most common osteoporotic fracture. Advanced surgical techniques, accumulated knowledge and practical experience, as well as new evolving implants have expanded the indications for surgical treatment. Dedicated studies, however, fail to outline any superior and convincingly outperforming surgical treatment option.

The objective is to find out most optimal treatment options by comparing the results in patients with proximal humerus fractures who underwent either blocked intramedullary osteosynthesis (BIOS) or osteosynthesis with precontoured angular stable LCP humerus plates (LCP).

Methods. The study included 534 patients with proximal humerus fractures who underwent surgical reconstruction between 2015 and 2024, including 503 (94.2%) patients undergoing BIOS and 31 (5.8%) patients undergoing open LCP repositioning.

Results and discussion. The treatment results were assessed in 173 (32.4 %) patients. The postoperative follow-up did not exceed 8 months. BIOS technique allowed to achieve favorable results in terms of absence of pain, restored joint function and scope of movement, as well as low re-operation rate. LCP osteosynthesis showed a slightly poorer performance for all the studies parameters.

Conclusion. Blocked intramedullary osteosynthesis is a safe and efficient treatment option in proximal humerus fractures, associated with reliable stabilization, minimized tissue trauma, intact blood supply, low risk of postoperative wound infection, decreased operation time, and early rehabilitation without complications. However, the use of intramedullary pins is not a ‘one-size-fit-all’ treatment strategy. The treatment decision should be supported by advanced diagnostics, taking into account the type of fracture, bone tissue quality and concomitant pathologies, as well as patient’s individual characteristics and expectations.

Relevance. Academic publications report ample evidence showing that throughout their studies in the institutions of military education cadets and their health is exposed to a combination of military service-specific factors. Military professional activity, strictly organized teamwork, intensified training in senior years of studies, and others factors can have a negative impact on the health of the military, leading to an increased number of working days lost to sickness absence among students and therefore impaired quality of higher military education in the Russian Armed Forces.

The objective is to elaborate specific morbidity-related factors among cadets studying at an institution of military education; the present study analyzes the case of the Kirov Military Medical Academy (St. Petersburg).

Methods. The morbidity rates among male (n = 1768) and female (n = 209) cadets who had completely recovered from the disease were studied based on their medical records and the results of annual medical examinations (n = 5151 and n = 621 respectively). The obtained morbidity rates were correlated with disease chapters of the International Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). The incidence rate was calculated in ppm (%). The results were verified for normal distribution; the mean values and standard errors (M ± m) were calculated. The dynamics of changes was evaluated using the dynamic analysis with 2nd order polynomial trends and the coefficient of determination (R2).

Results and discussion. The average long-term general morbidity among cadets throughout the 6 academic years’ study at a military university stood at 1149 %, including among men – 995.5 % and women – 2092.5 %. We noted an upward trend in the dynamics of the overall morbidity in the general group of the examined male and female cadets. Compared to male cadets, women had a significantly elevated total morbidity rate for all disease chapters, as well as higher statistics for the endocrine, nutritional and metabolic diseases (Chapter IV, ICD-10), diseases of the nervous system (Chapter VI), the circulatory system (Chapter IX), the respiratory system (Chapter X), the skin and subcutaneous tissue (Chapter XII), the musculoskeletal system and connective tissue (Chapter XIII) and the genitourinary system (Chapter XIV). When compared to year 1 at baseline, by year 6 of studies, the number of cadets in the healthiest health group I decreased by 1.3 times among men and 2.2 times among women; the less healthy health group II showed a decrease by 2.5 and 1.0 times for men and women respectively; while the least healthy health group III became more populated by 8.4 and 20.1 times for men and women respectively. The average long-term demand for screening among health group III cadets amounted to 228.3 %, including 200.6 % among men and672.5 % among women. Evidence showing upward dynamics in the cadets’ demand for screening is provided. Compared to male cadets, diseases of the eye and adnexa (Chapter VII), the circulatory system (Chapter IX), the musculoskeletal system and connective tissue (Chapter XIII), the genitourinary system (Chapter XIV), as well as the total morbidity rate for all disease chapters were statistically significantly higher in women requiring follow-up screening.

Conclusion. The increased general morbidity and demand for follow-up screening by the end of studies suggests that the current measures to preserve and strengthen the cadets’ health are insufficient and have low efficiency. At admission to institutions of military education, greater focus on health issues among applicants is required during medical examination.

Relevance. Currently, cholera poses a serious external infection risk for the Russia. Any region of Russia is at risk of cholera infestation/importation, while importation events shall be considered as a real threat to the sanitary and epidemiological wellbeing of the population. Every Russian region is characterized by a set of individual factors and conditions affecting cholera infection risks, as well as preparedness of medical and testing lab capacities. In such environment, every region of Russia is in critical need of region-specific stochastic epidemiological forecasting is critically demanded in the case of cholera infestation importation. Ability to select a most efficient rapid response strategy in every forecasted scenario is no less relevant.

The study objective is to use the developed epidemiological risk assessment score for cholera infestation/importation in individual regions of Russia to eventually establish the probability for each of the three potential epidemiological scenarios, as well as to guide scenario-specific rapid response strategies.

Methodology. Epidemic risk assessment score for cholera infestation/importation in Russia was developed based on region-specific quantitative evaluation of the potential epidemiological risk at public mass events and the overall epidemiological capacity in case of cholera exposure. Modifications included ranking the sets of assessment score indicators by cholera epidemiological risk exposure with a few extra sets of indicators, such as region-specific product output, economic factors, emergency incidence rate and scope of consequences. Stochastic scenarios are based on retrospective data analyzing the links between the initial epidemiological risk factors, preparedness of medical and laboratory services, and real country specific data regarding the development of the epidemiological situation amid cholera outbreaks.

Results and discussion. The study develops a region-specific epidemiological risk assessment score for cholera infestation/importation for Russian Federation regions to provide an insight into the impacts of epidemiological risk factors and counter-epidemic preparedness capacities of every region, considering the implementation of each of the three potential epidemiological situation scenarios (negative, limited spreading, and favorable). The paper elaborates strategies and solutions to provide efficient rapid response in case of either scenario.

Conclusion. The developed epidemiological risk assessment score for cholera infestation/importation in individual regions of Russia allows to evaluate the probability for each of the three epidemiological scenarios in a particular region depending on the total score, as well as to select most efficient scenario-specific rapid response strategies.

Relevance. Genetic determinants of multifactorial diseases are critical for assessing the risk of genetic diseases and their prevention, especially among the workforce exposed to industry-related dangerous and aggressive occupational factors. Firefighters perform combat service duties in extremely unfavorable industrial environments associated with occupational diseases. Respiratory diseases are among the pathologies with highest incidence rates in firefighters. In addition to environmental factors, the development of these diseases (especially bronchial asthma and chronic obstructive pulmonary disease) is largely driven by impaired immune system – one of the three critical regulatory systems involved in pathogenetic mechanisms of various diseases, including inflammatory diseases. Polymorphic gene variants of inflammatory mediators – in particular cytokine genes and their receptors – mediate the immune system activity and can impact its functionality, susceptibility, or resistance to disease development.

The objective is to analyze how interleukin 1β, 4, 6, 13, TNF and interleukin 6 receptor genes, as well as their polymorphic variants are associated with respiratory diseases and changes in the biomarker profiles showing immune response intensity in the employees of the Federal Firefighting Service of the EMERCOM of Russia.

 Methodology. Molecular genetic profiling and immunology tests were performed in 70 employees of the Federal Firefighting Service of the EMERCOM of Russia to analyze proinflammatory cytokine genes and their polymorphic variants. Real-timePCR was used to analyze the interleukin 1β, 4, 6, 13, TNF and interleukin-6 receptor genes and their polymorphic variants. Immunological examination evaluated the blood monocyte subpopulations and relative count of type 2 T-helper cells; flowcytometry and immunochemiluminescence assays were used to evaluate immune response biomarkers in peripheral blood and total immunoglobulin E (IgE) respectively.

Results and discussion. The analysis provides evidence that minor alleles of most polymorphic cytokine genes are associated with a proinflammatory phenotype, which is especially apparent for genotypes comprising several minor alleles. Allele A at rs1 800 629 polymorphic TNF gene exposed a direct correlation with respiratory diseases, as well as with increased monocyte differentiation. Allele T of IL4 rs2243250 gene and allele A of IL1β rs16944 gene were associated with increased proinflammatory monocyte count. Elevated count of type 2 T-helper mediators of humoral response, especially of allergicorigin, was observed in individuals with C/C IL6 rs1 800 795 and G/G IL1β rs16944 genotype.

Conclusion. The obtained results suggest that evaluation of cytokine gene polymorphic variants is a promising strategy to predict the risk of respiratory diseases in firefighters. Prompt assessment of genetic predisposition to a proinflammatory phenotype paves the way towards prevention and early detection of inflammatory diseases in this cohort of workers.

Relevance. Severe decompression sickness is the most common diving disorder; therefore, its diagnosis and prevention is considered important aspects of hyperbaric physiology and diving medicine. Diver’s susceptibility to gas bubble formation under decompression is most critical for decompression sickness prevention. Doppler bubble detection is the most common procedure to identify divers who are most susceptible to gas bubble formation under decompression; nevertheless, a more comprehensive examination including pulse pressure and 2D visualization of gas bubbles provide valuable advantages.

The objective is to provide justify the implementation of the decompression risk and venous gas bubble formation scale.

Methods. The study enrolled 42 divers who were examined for tolerance to gas bubble formation under decompression; gas bubbles were visualized using Doppler ultrasound. Next, the developed decompression risk and venous gas bubble formation scale was used to verify its efficiency and practical value.

Results and discussion. After hyperbaric exposure, 2D gas bubble visualization data were analyzed showing that 6 subjects (14.3 %) had no decompression-caused gas bubble formation (0 points); 9 subjects (21.4 %) scored up to 5 points, showing a small amount of gas bubbles during exercise; 22 subjects (52.4 %) scored between 6 and 15; whereas the remaining 5 subjects presented with gas bubbles at rest and a sharp increase in bubble formation during mild exercise. The obtained data suggest that the examined diver cohort included 13 subjects (31 %) with very high tolerance to gas bubble formation, 21 divers (50 %) showing average tolerance and 8 highly susceptible subjects (19 %).

Conclusion. During decompression, venous gas bubble formation scale has significant diagnostic value providing a tool to measure individual diver’s susceptibility to gas bubble formation. The scale allows to reduce the hyperbaric load by decreasing exposure on the ground at threshold pressure (0.4 MPa) and thus reduce the decompression time, based on sufficient evidence regarding individual susceptibility to gas bubble formation under decompression

Relevance. In the current international situation, despite augmenting threats to data security in the Russian Federation, the procedures granting access to classified information to the authorized military have not undergone any significant changes so far. The existing approaches and methods of selecting professionals to be authorized to access national security information (NSI) fail to consider the candidates’ personal profiles.

The study objective is to development of a set of methods allowing to assess and predict individual reliability of military professionals dealing with information security.

Methods. The Automated System for Psychophysiological Diagnostics of Addictive Behavior was used; it comprises 2 psychological questionnaires and 2 psychophysiological methods to assess individual reliability in 78 military professionals. Psychophysiological assessment is supplemented with stimuli relevant for data security. The examination required 15 to 20 minutes per each subject, including explanations and practice. To ensure that individual reliability assessment was of an expert level and unbiased, the professors and commanders were asked to complete a dedicated questionnaire per each subject. The results were analyzed using Statistica 12.0 software package.

Results and analysis. Once the subjects of various individual reliability scores completed all he automated assessments, the obtained database underwent a discriminant analysis. Eventually, a statistically significant model (p < 0.001) was developed per every subject to predict their personal reliability level. The model sensitivity was is 85.7 %, while the specificity was 100 %. The study identified the most significant psychophysiological markers of low reliability risk in students of higher military education institutions of the Ministry of Defense of the Russian Federation.

Conclusion. The developed automated system for individual reliability assessment in data security is registered in the Rospatent Computer Software Register under N 2024663045 dated 03.06.2024 as the “Automated System for Individual Reliability Assessment among the Military Having Access to National Security Information”. Unlike other well-known methods to identify the risk of data protection offences, the proposed tool is user-friendly and eliminates such types of bias, as distorted interpretation of results, investigator’s proficiency and experience, or the pursuit of the subject to provide socially favorable replies.