Vol 338, No 6 (2017)

The article provides information on defined organizational basics for emergency care delivery (ECD) in a multidisciplinary medical organization according to experience of the ninth treatment-and-diagnosis center of the Ministry of Defense of Russia. Authors reviewed regulating documents concerning emergency care delivery and first aid delivery, analyzed the importance of knowing of algorithms and principles of emergency care delivery in emergencies and critical conditions. The system of emergency care delivery organized in the center is shown, work of the emergency care department and outpatient care department is analyzed, issues and ways for their solving are determined. Costs for emergency care department and outpatient care are calculated, net cost for the service «Call for doctor-nurse team of emergency care department and outpatient care» its calculation and direct and indirect costs.

The article provides information, which shows that a significant proportion of mental disorders are detected outside psychiatric institutions, and most patients with them are treated in general hospitals. The choice as a basic model of cardiac pathology is caused by a wide range of its severity (from minor functional disorders to life-threatening conditions) and high prevalence of comorbid psychopathological disorders. Based on the study of the structure of psychopathological disorders (with the use of the rhythmological model of depressive disorders), three principal periods of their formation in 307 military men with urgent cardiological conditions and mental disorders substantiate the fundamental principles of organizing psychiatric care in a multidisciplinary hospital. The application of the proposed model contributed to a significant improvement in the quality of life of servicemen, their psychometric indicators, and the dynamics of the underlying cardiological disease.

In modern scientific literature, there are few works devoted to the study of the influence of pathogenic factors on the CAP ultrastructural organization of erythrocytes. Using atomic force microscopy and Raman spectroscopy for the assessment of physiological functions at the molecular level and submolecular offer new opportunities to clarify the pathophysiological regularities of the formation of the clinical picture of the disease in different categories of patients.The study included 55 patients with CAP. At 30 people diagnosed with non-severe CAP, 25 - severe.The control group consisted of 20 healthy non-smoking volunteers of similar age. Atomic force microscopy and Raman spectroscopy to study the micromechanical characteristics of red blood cells and the intracellular chemical structure in young patients with community-acquired pneumonia. It was found that all the patients at the height of the disease significantly decreased the ratio of the modulus of elasticity and strength of adhesion and the elastic deformation of the red blood cell count increased significantly. These changes were particularly noticeable in severe community-acquired pneumonia. So, set the close correlation between the parameters of endotoxemia, the level of arterial hypoxemia and elastic properties of cell membranes. Convalescents after severe CAP has kept changes micromechanical properties of cell membranes, which are recovered only after 3 months from the hospital. It is shown that in the examined groupof patients intracellular chemical structure of the red blood cells did not differ from healthy individuals, which may indicate stability gemoporfirins metabolic profile in these patients.

It is shown that an objective condition for ensuring the quality of medical care is an objective determination of the need for medicines, including those in infusion solutions, many of which are essential medicines. It is established that to determine the need for infusion solutions, a significant factor is the balance between the assortment and the number of acquired infusion solutions and the content of standards of specialized medical care, on the basis of which the medical organization carries out medical activities. The necessary data are presented to determine the indices of the need for infusion solutions, the main factors influencing the structure of their consumption, the mathematical formula for calculating the need for infusion solutions for a specific nosology.

The current paper is dedicated to analysis of the concept of «hybrid war». The aim of the article is to determine whether it is reasonable to employ this term in the domestic scientific discourse. The research has been based on free available foreign scientific publications. It has been established that the term «hybrid war» does not represent any definite subject matter. Different scholars put different meanings into it. Because of such vagueness the term has not been used in the official documents of the world largest armed forces, such as armies of the USA, member states of NATO, and People’s Republic of China. So it is inexpedient to use the term «hybrid war» in domestic science as well. Instead uncritical borrowing of fashionable foreign linguistic constructions it would be wise to endeavor the serious theoretical and applied research to build our own, Russian-language, terminological field which will adequately reflect the modern war and armed conflict phenomenology. And only after should one start on elaboration of the military medical aspects of the theme.

The author presents his own experience of surgical treatment of patients with pyoinflammatory soft tissue diseases in the field using lymphotropic and NO-therapy. The comparative characteristic of treatment of two groups of patients is described: the first - 18 patients with pyoinflammatory diseases of soft tissues, who were treated with the traditional modern method (surgical treatment and drainage of the focus, cefotaxin intramuscularly); The second - 34 patients underwent complex NO- and lymphotropic therapy. After surgery, lymphotropic administration of 1 g of cefotaxime was performed, and a day later the lymphotropic administration of the antibiotic was repeated and the wounds treated with air-plasma streams using the Plazon apparatus in a gentle coagulation regime or in the NO-therapy regime. The first group of patients was prescribed on the average on the 12th day after the start of treatment, and the second on the 8th day, which indicates that the treatment method used by us allows us to shorten the treatment time for patients with pyoinflammatory soft tissue diseases.

Evaluation of the effectiveness of osteopathic treatment of 50 military women aged 30 to 40 years with different types of disease: psychophysiological insomnia, a syndrome of chronic venous discirculation of brain, adhesive disease of the pelvic organs (operation history about 10-12 years ago) due to uterine myoma and cyst one or both ovaries. With the help of a question naire SF-36 was assessed in the dynamics of indicators of quality of life be fore and after osteopathic treatment. According to the correlation and factor (principal components) analyses the peculiarities of inter relations of indicators of the osteopathic status and quality of life before and after osteopathic treatment.

The article presents the main stages of formation and development of the antiphthisic specialized multidisciplinary military-medical organization. Within the last 65 years the staff of the brach has admitted for treatment mote than 40 thousands of patients with tuberculosis and performed about 15 thousands surgical treatments. For the last years the facility has become not only clinical but also methodological antiphthisic center in the Armed Forces of the Russian Federation.