Medical corps support to a brigade action during an offensive action including river crossing.

This paper describes medical support to a Croatian Army brigade of 2,100 soldiers in an attack combined with river crossing during the 1991/1992 war in Croatia. Three crossings across the river, 4,000 to 5,000 m apart, were used along a front of a total width of 14 km. The anticipated depth of the attack was about 4 km. It was estimated that the enemy had about 1,000 fortified soldiers supported by a corresponding number of artillery and other weapons. The medical corps were strengthened for this particular action by manpower and boats, and the soldiers by additional medical accessories (bandages and triangular slings). During the action, 78 Croatian Army soldiers were wounded, 7 were killed, and 8 were missing. The condition of the wounded soldiers did not worsen during transport. The mean duration of the transport was 90 minutes (maximum 2 hours). Twenty-six percent of the wounded were definitively treated by the brigade medical corps. One physician was included among the seriously wounded. The enemy had more than 150 dead and about 300 wounded. Upon achievement of the planned objectives, the action was interrupted by a high command decision and the brigade returned to its initial position.

Formation and organization of military medical service at the east Slavonia front in the 1991/1992 war in Croatia.

The work of the Croatian Army medical service of the Osijek Military District between July 1, 1991, and September 1, 1993, was analyzed. In the former Yugoslavia, Croatia was not allowed to have its own army. Therefore, the national armed force and medical corps had to be formed during the war against Croatia. Medical support to army units was initially provided by civilian medical services, i.e., by mobile surgical teams performing their tasks on the model of civilian ambulance services. Numerous objective obstacles, such as the lack of equipment, qualified military medical professionals, and experience in the organization and functioning of army medical corps, were encountered. Seventy-five members of the Osijek Military District medical service were killed, wounded, or missing. There were 145,410 recorded and treated cases of various diseases, 21,767 (14.6%) of them referring to war wounds. Forty-three medical vehicles were demolished and 20 were damaged. At present, transformation of the Croatian Army to a peacetime organization is under way.

Thyroid hormone economy in response to extreme cold exposure in healthy factory workers.

The effects of cold exposure on serum total T4 (TT4), total T3 (TT3), free T4 (FT4), free T3 (FT3), rT3, TSH, T4-binding globulin (TBG), and T3 resin uptake were investigated in 82 euthyroid factory workers. Twenty-five workers (group 1) were exposed intermittently (approximately 3.5 h daily) to extreme cold (-40 to -20 C) during the 8-h work shift, and 47 (group 2) were exposed to moderate cold (-10 to 8 C) for the entire 8 h. Ten individuals working at room temperature for the same period also were studied. After cold exposure, serum TT4 decreased in group 1 and did not change in group 2, whereas FT4 did not change in group 1 and increased in group 2. After exposure, serum TT3 and rT3 decreased significantly in both groups, while FT3 did not change in either. The basal serum TT4 levels in groups 1 and 2 were significantly lower than those in the control group, whereas those of FT4 and FT3 were higher. Thus, cold exposure had opposite effects on total thyroid hormones and their free fractions, consistent with a cold-induced decrease in thyroid hormone-binding capacity. A postexposure decrease in serum TBG was found in women in group 2, but not in men in either group 2 or group 1, suggesting that factors other than decreased TBG are also involved. The results suggest the possibilities that 1) decreased thyroid hormone-binding capacity is an adaptive response to cold exposure, and/or 2) increased free thyroid hormone levels in response to cold exposure result in a new higher equilibrium between extracellular and intracellular FT4 and FT3.