Introduction Ukraine’s health and trauma system has been detrimentally impacted since the Russian Federation invasion in February 2022. The number and extent of injuries experienced in Ukraine because of trench warfare and high-intensity large-scale combat operations has not been seen in recent conflicts. Understanding attitudes and perceptions around the use of devices and products including MOVES (monitor, oxygen concentrator, ventilator, and suction system) and its use in the large-scale combat operation environment can inform lessons learned for improved prehospital care in Ukraine, as well as in other future conflicts. Material and Methods We conducted qualitative key informant interviews with military and civilian Ukrainian health care workers during the ongoing conflict using an expanded version of the Global Trauma System Evaluation Tool. We focused the analysis on identifying and understanding the capability of MOVES Micro-integrated Life Support System (SLC). Results Thirty-six participants were interviewed; 56% were military and 44% were civilians and representative of all NATO roles or levels of care. Sixty-one percent of participants were male. Seventy-two percent of participants were stationed in the Eastern and Northern regions. The mean age was 34.9 years. Sixty-seven percent of care providers reported using MOVES SLC and the remainder stated they wanted the device. The device was sometimes referenced as a “portable ventilator.” Of other donated surgical equipment, MOVES SLC was described as “unique.” A stabilization modification was suggested as a need given the ad hoc vehicles used for en-route critical care. Participants reacted positively to using MOVES SLC and the capabilities and improvements in care that MOVES SLC can provide for en-route care of critically injured patients. Conclusions MOVES SLC is well regarded by Ukrainian trauma care providers. Training may be necessary to increase the quality of care when utilizing these devices, and vehicle modifications may be necessary for use given some concerns over the equipment falling during transport. There is a need to study how this equipment improves the ability of limited medical personnel to provide prolonged care for a larger number of patients with reduced medical resupply.
Introduction Ukraine's health and trauma system has been detrimentally impacted since the start of the Russian invasion in February 2022. Use of telemedicine became critical to providing timely medical care. As such, the aim of this study was to describe telemedicine's use in the health and trauma system of Ukraine following the full-scale invasion. Methods We conducted qualitative key informant interviews with military and civilian health care workers using an expanded version of the Global Trauma System Evaluation Tool which had components focusing on telemedicine use. Thematic content analysis was used to derive key telemedicine themes from interviews. Results We conducted 36 key informant interviews. Most respondents described using telemedicine through informal means of communication such as messaging apps to meet patient care needs. Concerns and challenges with use of telemedicine included weapons targeting, internet connections and safety of communications from Russian hackers. A unified system for telemedicine would greatly improve use in country both during and post conflict. Discussion Telemedicine use has rapidly increased in Ukraine during the current conflict particularly in the scope of providing trauma care when numerous specialties are needed. Development of a unified, secure telemedicine system with mechanisms for integrating multinational medical support would aid in providing swift medical care to persons injured in the conflict or unable to access a specialty provider in their proximity.
Збірка містить тези доповідей науково-практичної конференції з міжнародною участю, присвяченої вісімнадцятим марзєєвським читанням «Актуальні питання громадського здоров’я та екологічної безпеки України» Конференція проходила 21-22 жовтня 2022 року у Києві.
Голова оргкомітету академік Національної академії медичних наук України Сердюк А.М.
Introduction. Vitamin D deficiency is currently considered a global epidemic. Recent data highlight its pivotal role in the d of metabolic disorders, including obesity in children and adolescents.
The functionality of redox metabolism is frequently named as an important contributor to the processes of aging and anti-aging. Excessive activation of free radical reactions accompanied by the inability of the antioxidant defense (AOD) mechanisms to control the flow of the reactive oxygen species (ROS) leads to the persistence of oxidative stress, hypoxia, impaired mitochondrial energy function and reduced ATP potential. From a long-term perspective, such changes contribute to the development of chronic diseases and facilitate aging. In turn, preconditioning of a biosystem with small doses of stressful stimuli might cause mobilization of the mechanisms of AOD and control an excessive flow of ROS, which supports optimal functioning of the redox reactions. Those mechanisms are of crucial importance for anti-aging and are also known as a eustress or hormetic response. To ensure continuous support of mild pro-oxidant activity in a metabolic system, close monitoring and timely corrections preventing the development of excessive ROS production are required. The paper introduces the potential of heart rate variability (HRV) as a biomarker of functional and metabolic reserves and a tool to measure stress resilience during aging. The practical approaches to interpretation of HRV are provided based on total power, changes in total power in response to an orthostatic test and activities of all spectral components. It is suggested that the complex of those parameters can reflect the
depth of oxidative stress and may be used to guide lifestyle interventions and promote active longevity.