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The analysis of injuries, life-threatening consequences and outcomes of treatment of wounded with penetrating chest wounds and the results of approbation of a prototype (medical) disposable set UD-02v for the elimination of strained and open pneumothorax, hemothorax, pleural drainage and collection of spilled blood with the possibility of subsequent reinfusion at the pre-hospital stage is presented. The prototype of the UD-02v set was created as part of the implementation of the state defense order in 2018. Its creation is due to the fact that despite the improvement of medical care at the stages of medical evacuation and the widespread use of individual armor protection, chest injuries currently remain a frequent type of combat surgical injury, accounting for 6 to 12% of all injuries. The main cause of death of injured and injured with chest injuries remains blood loss caused by continuing intrapleural bleeding and concomitant damage to other anatomical areas. Stressful pneumothorax, together with intrapleural bleeding, account for 93% of preventable causes of fatal chest injuries at the pre-hospital stage. Untimely elimination of the consequences of severe breast injuries should be considered as a negative factor affecting the outcome of treatment, and significant improvement in treatment results should be expected only in the case of early elimination of the most severe consequences of breast injuries. The developed set of UD-02v exceeds foreign medical devices in its medical and technical characteristics, and is the most promising for acceptance for the supply of the Armed forces of the Russian Federation as part of the samples of complete and service equipment.

451 lethal outcomes of 5581 casualties with gunshot wounds occurring at the medical treatment facilities have been analyzed. Total lethality rate was 8,1%. Lethal outcome time varied from 1 to 19 days (10,61,9). 50,3% of casualties died during the advanced trauma management (Role 2), 17,3% at the Role 3 hospitals, 32,4% at the Role 4 hospitals. The predominant injury localization causing death was abdominal wounds 34,8%, and head injuries 23,1%. The main cause of death of wounds casualties arriving at the medical treatment facilities was life-threatening injury consequences (34,8%) and developing complications (45,5%). Fatal injuries to the major organs and permanent blood loss were considered to be the cause of death in 19,7% of casualties. 37% of the total number of lethal outcomes died because of acute blood loss, in 77,2% of cases it was internal hemorrhage, in 22,8% external hemorrhage. In 1% of cases early death was caused by acute respiratory failure. In general, the development of more than one third of lethal outcomes could be prevented. Special medical products and equipment were developed by the Department of War Surgery Kirov Military Medical Academy, RF Ministry of Defense in cooperation with the leading research and educational establishments and production enterprises. They are: equipment for the prehospital hemorrhage control, asphyxia management, open and tension pneumothorax management, traumatic shock treatment and complication prevention, as well as activities for creating devices controlling internal hemorrhage. All these form the basis for elimination of life-threatening consequences of injuries at the prehospital stage. This allows us to discuss the development of the idea of a traumatic disease, being put forward by professor Ilia Deriabin, in terms of the concept of the early-stage pathogenetic treatment of the severe injuries and traumas.

One of the reasons of growing incidence of tuberculosis (TB) is spread of AIDS, drug dependence, and alcoholism. To investigate their mutual influence the authors examined 185 lung TB patients (of them, 124 males) admitted to TB hospitals of St-Petersburg in 2003-2005. Inclusive criteria were age of 18 to 79 yrs, recent admission to the hospital, the patient's consent to participate the study. Patients were excluded if they were severely ill or had psychiatric disorders. The lung TB was evaluated using medical history, physical, clinic, laboratory, radiologic, and bacteriologic data. Alcohol and drug abuse was assessed with Addiction Severity Index (ASI), retrospective analysis of alcohol and substance use for previous 90 days, Michigan Alcohol Screening Test (MAST), measurement of alcohol in exhaled air and detection of substances in urine. Somatic and psychic health was evaluated using ASI, Beck Depression Inventory, and Spielberger Trait Anxiety Inventory. Risk of HIV-infection was determined in a test of HIV risk assessment and with HIV risk questionnaire developed at Johns Hopkins University. The average age of the participants was 40.5 yrs. More than 60 % of them had abuse-related disorders: alcohol abuse in 51.9 %, alcoholism plus drug dependence in 8.6 %, and drug dependence in 3.8 %. Alcohol dependence facilitated development of TB multiple drug resistance (21 % vs 7.6 % in patients without alcohol dependence, p < 0.05), extensive (73.9 % and 40.9 %, respectively, p < 0.001) and chronic (28.6 % and 16.7 %, respectively) forms of TB. Most of TB patients with abuse-related disorders tended to have psychiatric disorders (depression, anxiety). The risk of HIV-infection was significantly higher in TB patients with drug abuse (3.51 vs 0.07). Thus, it is necessary to consider co-morbidity in TB patients for more effective treatment of lung tuberculosis.