Organización de la cuarentena hospitalaria en los evacuados de Wuhan al inicio de la pandemia de COVID-19 / Hospital organization quarantine in Wuhan evacuees at the start of the COVID-19 pandemic

INTRODUCCIÓN: El 31 de diciembre de 2019, la Organización Mundial de la Salud fue informada de un grupo de casos de neumonía de etiología desconocida detectados en la ciudad de Wuhan (China). El 30 de enero de 2020, se declaró el brote de nCoV-2019 (posteriormente SARS-CoV-2) como una emergencia de salud pública de preocupación internacional. En este contexto, algunos países occidentales, decidieron evacuar a sus ciudadanos. OBJETIVOS: En este artículo se describe el planteamiento llevado a cabo en el caso de las personas evacuadas desde Wuhan a su llegada a España. MATERIAL Y MÉTODO: Se recopiló información sobre los criterios para seleccionar las instalaciones y el personal, el número de casos en cuarentena, la estrategia de control de infección, la duración de la cuarentena, la monitorización clínica y otros aspectos relevantes. RESULTADOS: Las autoridades sanitarias españolas seleccionaron el Hospital Central de Defensa Gómez Ulla para realizar una cuarentena hospitalaria. Veintiuna personas fueron trasladadas de Wuhan a Madrid, incluidos dos niños. Los médicos de medicina preventiva y enfermedades infecciosas fueron seleccionados para dirigir y asistir la vigilancia. Las visitas fueron autorizadas siguiendo un protocolo establecido. CONCLUSIONES: Este es el primer informe sobre cuarentena hospitalaria para SARS-CoV-2, diseñado específicamente para repatriados. La cuarentena hospitalaria podría ser un método útil para casos seleccionados de enfermedades altamente contagiosas. Sin embargo, se necesita un buen soporte de recursos e instalaciones, selección de personal experimentado y protocolos revisados

INTRODUCTION: On December 31, 2019, the World Health Organization was informed of a group of cases of pneumonia of unknown etiology detected in the city of Wuhan (China). On January 30, 2020, the nCoV-2019 outbreak (later SARS-CoV-2) was declared a public health emergency of international concern. In this context, some western countries decided to evacuate their citizens. AIM: This article describes the approach taken in the case of people evacuated from Wuhan upon arrival in Spain. METHODS: Information was collected on the criteria for selecting facilities and personnel, the number of quarantine cases, the infection control strategy, the duration of quarantine, clinical monitoring, and other relevant aspects. RESULTS: The Spanish health authorities selected the Gómez Ulla Central Defense Hospital to carry out a hospital quarantine. Twenty-one people were transferred from Wuhan to Madrid, including two children. Preventive medicine and infectious disease physicians were selected to direct and assist surveillance. The visits were authorized following an established protocol. CONCLUSIONS: This is the first hospital quarantine report for SARS-CoV-2, designed specifically for returnees. Hospitalarian quarantine could be a useful method for selected cases of highly contagious diseases. However, good resource and facility support, selection of experienced staff, and revised protocols are required

[Software and hardware system for medical equipment recording in a military field hospital].

Software and hardware system for medical equipment recording in a military field hospital. The article provides characteristics on the modern software and hardware system for recording of medical equipment in a military field during military time. This system is included into the assembly of medical equipment , included in the norms of medical equipment supply for military field hospitals. Authors give an algorithm of development and use of specialized software for recording of-medical equipment in a military field hospital.

[Organization of medical equipment supply for the Russian Army during the First World War].

Organization of medical equipment supply-for the Russian Army during the First World War. The article shows that when preparing the army for the war and planning of emergency supplies for military time the Russian military department was guided by the experience gained during the Russo-Japanese War, which turned old by that time, and as a result during the First World War the medical service noticed a significant lack of medications,surgical instruments and other medical equipment. There were few bases of medical equipment in the troop district. The undertaken emergency measures allowed improving supply of medical institutions and troops with medical equipment.

[Improvement of medical equipment setting for the hospital link of the medical service during wartime].

One of the priorities of the military health care is to improve the system of rationing medical equipment for the hospital unit of the medical service of the Armed Forces in wartime. This is determined the fact that the effectiveness of measures to provide military field hospitals with medical supplies depends on the quality of medical care for the wounded and sick, as well as the level of their return to duty. The article presents the characteristics of modern standards medical supplies procurement of military field hospitals included in the new regulatory legal act of the Russian Federation Ministry of Defence--"Standards of supplies medical supplies medical and pharmaceutical organizations (units) of the Russian Federation on the wartime armed forces", approved and put into effect in 2015 by order of the Minister of Defence of the Russian Federation.

Contribution of the 320th central warehouse to sanitary medical support of the Red'Army during the Great Patriotic war.

During the Great Patriotic war (1941-1945) medical supply experts of the 320th Central warehouse sanitary solved complex problems for the regular and complete provision with medical property guide action by the army, the formation of complete basic equipment, service of medical transport and medical equipment. The experience gained in providing acting army allowed in the post war period progressively develop functioning of the system of medical supplies of troops (forces), successfully and smoothly carried out in the framework of its organizational planning and other activities.

La salud y la enfermedad en el Real Hospital de la Armada del Arsenal de la Carraca (1756-1821) / Health and disease in the Real Hospital de la Armada of the Arsenal de la Carraca (1756-1821)

En el primer cuarto del siglo XVIII se crea el Arsenal de la Carraca, considerado como el principal astillero de la Armada Española. La masiva llegada de operarios civiles y militares ante la oferta de trabajo, motivó un problema asistencial sanitario, que se solventó a través de una improvisada enfermería de madera y otros hospitales provisionales instalados en la Isla de León. Finalmente, en 1756 se pudo fundar el «Real Hospital del Arsenal de la Carraca». Este nosocomio tuvo un papel crucial en la epidemia de fiebre amarilla de 1800 y en los dos primeros años de la Guerra de la Independencia, hasta que en agosto de 1810 tuvo que ser desalojado ante el riesgo de bombardeo de las baterías francesas apostadas en Puerto Real, siendo reconvertido en un «hospital de sangre». No obstante, en la segunda grave epidemia de fiebre amarilla de 1819, el hospital tuvo que ser reactivado como en sus orígenes. Debido a la restructuración hospitalaria en la bahía de Cádiz, la Armada procedió a su extinción en el año 1821, tal y como muestra el documento que lo acredita encontrado en el Archivo General de Marina «Álvaro de Bazán». En este trabajo se exponen las vicisitudes sanitarias y humanas de este Real Hospital a lo largo de 65 años claves en la historia de España

In the first quarter of the 18th century the Arsenal de la Carraca was created and soon after considered the most important shipyard of the Spanish Navy. The massive arrival of military and civilian employees as a consequence of the job offered, brought about a health care problem. This trouble was resolved by an improvised wooden sickbay and other several provisional hospitals placed in La Isla de León. Finally, the Real Hospital del Arsenal de la Carraca was established in 1756. It played a crucial role in the 1800 Yellow Fever Epidemic and in the first two years of the War of Independence until August 1810, when it was forced to evict considering the risk of a bombardment by French batteries settled in Puerto Real; then it was retrained as a ‘blood hospital’. Nevertheless, the hospital was established as it was originally because of the second serious 1819 Yellow Fever Epidemic. As a result of that reorganization in the Bahia de Cádiz, the hospital was closed down by Spanish Navy in 1821, as it is demonstrated by its supporting document founded in the Archivo General de Marina ‘Álvaro de Bazán’. This work expounds the sanitary conditions and human mishaps of this Real Hospital over 65 key years in the Spanish history

[Medical support of the Armed Forces of the Russian Federation: the results of the activities and the main tasks for 2015].

Presented the directions of activity of the medical service in the past year, including improving the legal framework, the optimization of medical management software, improving combat and mobilization readiness of units of the army, the optimization of therapeutic and preventive activities, implementation of innovative technologies, increasing mobility of units and subunits, their level of equipping with modern samples of property, training of qualified personnel, intensify research and etc. Analyzed and formulated directions of development of military medicine in 2015, including improvement of combat and mobilization readiness of the management body, military and medical organizations and departments, improving the legal framework of the military health care, holding among the troops interventions for the prevention morbidity of personnel by pneumonia and meningitis, work with commanders at all levels to ensure the preservation and strengthening of health of servicemen, improving of the system of early and active detection of diseases in the military, providing a guaranteed level of care to all contingent Ministry of Defense, improving the quality and accessibility of sanatorium treatment, maintaining constant readiness of medical special forces to carry out tasks for the purpose, improvement of professional training of personnel of the medical service, providing qualitative preparation of government medical service to participate in the training of troops, implementation of unexpected problems, equipping of army medical service with modern medical equipment finishing of the construction and renovation of military medical organizations facilities, improvement of social protection of personnel and many others.

[Medical support of the 65th Army during the East Prussian offensive operation performed by the 2nd Belorussian Front].

Prussian offensive operation performed by the 2nd Belorussian Front. An activity of the medical An activity of the medical service of the 65th Army during the East Prussian offensive operation performed by the 2nd Belorussian Front is a typical example of the medical support of troops during the final stages of World War II. Forms and methods of medical support management, which were developed during the war, haven't lost their importance in modern conditions. These methods include the establishment of specialized surgical and therapeutic field hospital, establishment of medical institutions in the Army, which worked on the evacuation directions and reserve of mobile hospitals and transport, timely extension of the first echelons of the hospital base front to change institutions hospital deployed the army base. A research of experience in organizing medical support of the offensive operations performed during the last year of World War II provides the material for the development of the theory of modern medical support operations and ability to provide on this basis, the continuity of the hospitals, the continuity of qualified and specialized medical care, improve the performance of diagnostic and treatment work.

[Development of different approaches to classification of medical equipment sets].

The authors provided results of the study on approaches to the classification of medical equipment sets for the medical service of the Armed Forces. A retrospective analysis of the formation and development of classifications of first aid kits, medical bags, sets of medical equipment, medical kits and kits is performed. Basic factors influencing the structure and principles of classification sets of medical equipment are detected. The authors present modern classification of sets of medical equipment and the ways of its improvement.

[Main types of activity of specialists of medical and preventive profile in military hospitals].

Infection prevention in medical organizations is an essential task to ensure quality of medical care and create a safe environment for patients and medical staff. The main task of a specialist of medical and preventive profile in the hospital is to maintain sanitary and epidemiological safety and control fulfillment of a complex of preventive measures. To achieve these goals specialists monitor epidemiological and microbiological fulfilment of the implementation and effectiveness of preventive measures, which allow to except infection entry to the hospital and possible carrying out beyond the hospital, occurrence and spread of disease. An obligatory activity of the specialist of medical and preventive profile in the hospital is a scientific and methodical work. The authors propose adoption of preventive structural subdivisions to the state largest diversified military hospitals.

[Improvement of the system of medical equipment rationing for military units in peacetime].

We present characteristics of a new regulatory act issued by the Ministry of Defense of the Russian Federation - Medical equipment supply rate for large units, military units and facilities of the Armed Forces of the Russian Federation in peacetime, prepared in the course of modernization of the system of medical equipment rationing. New system of medical equipment rationing answers modern requirements of the Armed Forces. Introduction of modern norms of medical supply into practical activities of military regulatory bodies, medical units, military units and organizations will increase the effectiveness and quality of medical service, will help to maintain servicemen's health and will facilitate the combat readiness of medical units.

[The Russian Armed Forces Military Medical Service: condition and ways of improvement].

In 2013 the main efforts of the Medical Service were aimed at the following tasks: optimization of management system of military medical service, improvement of medical evacuation system, medical service security for military contingents, assigned according to territory principle to military-medical facilities of the Ministry of Defence of the Russian Federation, implementation of innovations at all stages of medical evacuation in peace- and wartime, security of combat and mobilization readiness of regulatory bodies of the Medical Service, medical military units and military medical facilities, medical service of troops battle training, improvement of material and technical resources, security of regular pharmacy and equipment supply, activation of research work in the Medical Service interests. Lines of military medicine development in 2014 are: transfer of treatment facilities that are not used by the Ministry of Defence into the Federal Biomedical Agency till the end of 2014, prevention of pneumonia and meningitis in military personnel, improvement of early diagnosis system, medical service for military contingents according to territory principle, improvement of diagnostic and treatment work in military-medical units and subunits and military-medical facilities by means of development of material and technical resources, monitor the implementation of innovative diagnostic and treatment technologies, completion of construction projects of central military hospitals and etc.

[Evaluation of muscle relaxant requirement for hospital anesthesia].

The rationale for cost-effectiveness of modern muscle relaxants (MR) administration in general anesthesia was evaluated. New MRs are more expensive than traditionally used pipecuronium and succinylcholine. However, the old MRs are often required as a block reversion with anticholinesterase medicines at the end of surgery, the longer artificial lung ventilation and observation in patients during recovery in intensive care unit. It was found that the district military hospital had done an annual average of about 900 general anesthesia assisted with artificial ventilation and muscle relaxation. About 2% of all anesthesias accrue to short-term anesthesia, the 27% to medium-term and 71% to long-term. 81% of the medium-term anesthesia accrue small hospitals. According to cost/effectiveness the most optimal muscle relaxants administration scheme for short-term (up to 30 min) anesthesia was mivacurium, for the operation of medium duration (30-120 min)--rocuronium, for long-term (120 min)--pipecuronium. An electronic form of annual report, which allows to obtain the necessary data for calculation of annual muscle relaxants demand and costs both in hospital and in the whole of the armed forces quickly, was developed.

[Results of activity and purposes of the medical service of the Armed Forces of the Russian Federation].

The article presents whole range of activity of medical service of the Army and Navy. There were defined main directions and peculiarities of medical supply of the Armed Forces in conditions of forming of a new image. A special attention was paid to questions of combat and mobile readiness of medical armed units and institutes taking into account optimization of structure and quantity of medical service of the AF of RF. The main direction of activity of the medical service is organization of treatment-prophylaxis work for saving of life and health of the staff of Army and Navy. The article informs about stabilization of morbidity by the most popular diseases, about capabilities of medical service of armed unit in a new organization-staff structure, about ways of increasing of effectiveness of activeness of military treatment-prophylaxis institutes.

[Problem of resource supply of medical aid to wounded and damaged persons of neurosurgical profile].

Longstanding complex examination of problems of delivery of medical care to patients of neurosurgical profile, effectuating in Military-medicine academy by Kirov S.M., permitted to observe evacuation and treatment of patients of neurosurgical profile, their social rehabilitation and returning to their work, estimated the advantages of 2-stages evacuation of patients and delivery in hospitals of Center in comparison with multistage one. Were examined questions of rehabilitation, help to families of lost or invalid military servicemen. The authors, observed economical and social questions, made a conclusion: patients of neurosurgical profile have to receive medical care in specialized and equipped institutes of central level of rear of state occurring once and in full volume.