Voenno-medicinskij žurnal

The purpose of the study is to develop proposals for the application of methods and technologies of re-engineering in the tasks of medical support based on a comparison of the existing and proposed (prospective) medical support systems. The importance and necessity of re-engineering the services of chief medical specialists and the medical support system are shown. Quite new concepts and the possibility of their application in solving the problems and tasks of medical support are considered. Comparison of the existing and proposed (prospective) system of medical support is made. Proposals have been developed for the application of methods and technologies of re-engineering in the tasks of medical support for the population and troops. The redesign of medical processes carried out in the course of digital transformation and re-engineering will make it possible to achieve a much greater effect in the organizational, information-analytical, methodological and, of course, clinical activities of medical specialists.

The purpose is to evaluate the effectiveness of regional conduction anesthesia in the surgical treatment of patients with shrapnel wounds of the lower extremities in terms of hemodynamic parameters. A prospective cohort study of patients (n=122) operated on for shrapnel wounds of the lower extremities was performed. Patients were divided into 4 groups depending on anesthesia. It has been established that the use of regional conduction anesthesia with blockade of the peripheral nerve under ultrasound control, in contrast to intravenous and local infiltration, allows maintaining the values of blood pressure and heart rate within the normal range during the entire observation cycle, including periods of surgery and dressing, as well as two-hour intervals after the performed procedures. Patients showed a statistically significant increase in the diameter of the major arteries of the lower extremities after surgery, which persisted throughout the entire period of postoperative administration of the anesthetic.

Purpose of the study: to assess the incidence and clinical features of drug-induced anaphylactic shock to beta-lactam antibiotics, errors in its diagnosis and treatment in military medical organizations using the example of the Eastern Military District. An analysis of 190 case histories over a 9-year period (2014–2022) showed that complications to antibacterial drugs accounted for 46.6% of the total number of drug allergy cases, and anaphylactic shock in 5.7% of cases. More often, shock developed with the use of beta-lactam antibiotics. A number of main problems have been identified: the formal collection of an allergic history in patients with respiratory infections, the widespread, often unreasonable use of antibiotics for intravenous administration in respiratory viral infections, the weak alertness of clinicians in the development of anaphylaxis when prescribing drugs. Failures in the treatment of shock in most cases are associated with the late introduction of epinephrine or the use of its low doses, delayed resuscitation. Recommended anti-shock kit for procedural, dental rooms.

It carried a study of the intestinal microbiota out in 120 cadets of an educational institution that make up an organized team of a closed type. Performed cultural analysis of the biomaterial obtained from the lumen of the colon with inoculation on nutrient media of the extended list. A violation of the composition of the intestinal microbiota, expressed in quantitative and qualitative signs was revealed. The opportunistic flora prevailed in the intestinal microbiota. The occurrence of representatives of the genus Klebsiella was 49.2%. A pronounced predominance of transient intestinal microflora is shown: Aspergillus spp. found in 52.5% of cases. A statistically significant correlation dependence of the occurrence rate of Klebsiella spp. among cadets who arrived from various federal districts. The data obtained indicate the need to form a new concept of «healthy microbiome» among cadets/students of educational institutions to carry out preventive measures in order to reduce the risks of alimentary-dependent diseases, as well as diseases of other infectious and non-infectious etiologies.

Illusions of the spatial position are not a pathological process, it is a natural result of the functioning of the human senses in unusual conditions, and often occurs in pilots in a state of separation from the ground. The most dangerous outcome of attitude illusions is spatial disorientation, which is one of the most common causes of aircraft accidents. Prevention of spatial disorientation of the flight crew should include measures of psycho-physiological and psychological preparation. An effective method of training flight crews is training on special simulators and dynamic flight simulators. A variant of a console-type dynamic flight simulator is presented, which has no analogues in the country. Its technical capabilities make it possible to simulate the main situations that are psychophysiological prerequisites for the development of spatial disorientation, to work out physiological and psychophysiological ways to overcome the illusions of spatial position.

The experience of wars and armed conflicts shows that military medicine must be equipped with modern equipment for the search for, the speedy removal from the battlefield and the evacuation of the wounded and sick, as well as for the deployment of mobile medical stations. The tactical and technical characteristics of the protected ambulance of domestic production «Medical transporter ZSA-T» (for searching, collecting and removing the wounded from the battlefield and centers of mass sanitary losses) are analyzed, they are compared with similar armored medical vehicles of foreign manufacturers and indicators of the technical level are determined the perfection of all samples. It has been established that, according to the level of technical perfection, 3 samples, including ZSA-T, can be attributed to modern ones. The ZSA-T is not inferior to the best models of armored medical vehicles of foreign manufacturers in terms of its main parameters and makes it possible to ensure the speedy movement of the wounded from the battlefield to the subsequent stages of medical evacuation with a high level of protection against firearms and mines.

The purpose of the study was to assess the clinical and laboratory features of the course of COVID-19 in children hospitalized in the pediatric department during different periods of the pandemic. 515 case histories, 170 medical records of pupils of the boarding school of the Ministry of Defense were analyzed. It assessed clinical and laboratory parameters in different periods of the pandemic associated with various variants of the SARS-CoV-2 virus. The primary groups were formed according to the criteria for a clinically pronounced course of coronavirus infection, asymptomatic COVID-19 and the number of cases of COVID-19 during the pandemic period. Because of the analysis of 101 child development maps, the dominant groups of children with complaints after suffering COVID-19 in the form of post-covid syndrome were identified. The results of vaccination «Gam-covid-vac M» among teenage girls of the boarding house are presented. Despite the predominantly mild course of this disease in children, post-COVID syndrome is common, which significantly worsens the well-being and health of children. Timely examination and detection of post-COVID syndrome will allow choosing a personalized approach to its correction.

The article presents data on the major cases of the use of chemical weapons in military conflicts and acts of chemical terrorism from ancient times to the present. Particular attention is paid to the chronology of chemical attacks carried out in the period from 2015 to 2020. It outlined the main historical stages in the development of chemical weapons. Brief biomedical characteristics of some probable agents of chemical terrorism are given. Modern information about the international regulation of the use of chemical weapons is given. The methods of combating chemical terrorism, the primary tasks and directions of activities to counter the use of poisonous substances in armed conflicts and in the commission of terrorist acts are outlined. The importance of the readiness of medical services to provide emergency assistance to the injured and participate in the elimination of the consequences of the use of chemical weapons is shown.

Branch No.12 of 1586 of the Military Clinical Hospital of the Ministry of Defense of the Russian Federation, Pushkino, Moscow Region, Russia

A brief report on the XII Congress of Russian Phthisiologists held on April 25–27, 2023 in Grozny (Chechen Republic) is presented. The Ministry of Health of Russia and the National Medical Research Center for Phthisiopulmonology and Infectious Diseases of the Ministry of Health of Russia organized the congress in collaboration with the All-Russian Public Organization «Russian Society of Phthisiology» and the National Association «Association of Phthisiology», which summed up the results of the activities of the country’s TB service, formulated new tasks for improving specialized medical care and ways to solve them to continue the successful implementation of the problem of combating tuberculosis in Russia.