卷 339, 编号 3 (2018)

The article describes the impact of modern armed conflicts on civilians. It is shown that armed conflicts are increasingly being conducted in populated areas with the use of explosive forces by opposing forces. Its use in populated areas is associated with high mortality rates among the civilian population, which is due to the greater severity of injuries suffered by them. The most vulnerable category is women and children. The destruction of the infrastructure of populated areas has a very negative effect on the conditions for rendering medical assistance to the civilian population and on the sanitary and epidemiological situation in the area of combat operations and beyond. When planning military operations in populated areas, it becomes necessary to calculate not only the magnitude and structure of sanitary losses among civilians, but also indirect damage to their lives and health.

Postal bioterrorism - a threat to modern public society. The article is dedicated to the issues of the use of pathogenic biological agents for the contamination of post letters for terrorist purposes. It contains data about the psychotraumatic effect on people of the fact of the use of biological means by the terrorists and of the unpreparedness of public healthcare system to such kind of events. It covers the main problems of enhancing biological security of the recipients of postal correspondence, connected with the possibility of terrorist attacks with the use of the contaminated letters. The focus of this article is the list of pathogenic microorganisms, particularly dangerous in case of terrorist attacks using post letters. The main criteria for including certain microorganisms in this list are the degree of their potential epidemic danger, their resistance to external environmental factors and to means of disinfection. A special attention in the struggle against the postal bioterrorism is paid to the problem of enhancing the biological security of final recipients, as well as of the personnel, working with the postal correspondence, containing pathogenic biological agents.

The severity of injury affected by thermal burns is diagnosed by the ICP-10 empirical criteria and the severity index of damage. Their use and frequent identification with the severity of the condition is a crude methodological error. The area and degree of injury are the quantitative characteristics of the injury. They cannot be nominated qualitatively, they can only be «appointed». The results of studies on these criteria are not reproducible; therefore, it is impossible to create a theory of burn injury based on them, as well as standards and recommendations on treatment tactics, even if the number of scientific studies is multiplied. The hypothesis of the system-forming role of the severity of the state contributes to the solution of the problem. The key to determining the severity index of a condition is the procedure for finding the probability of a lethal outcome according to one of the tables, including the patient’s age and 1) the total area of the burn or 2) the area of deep lesion. The tables were created with the help of bliss analysis on the outcomes of conservative treatment of 10 000 patients. According to the hypothesis, the determination of the area and degree of burn is dictated by the necessity of diagnosing the severity of the condition in nominal categories, based on which recommendations and standards for the treatment of victims are formed. The severity of the injury is always determined individually and only through the severity of the condition of the victim.

The results of a pilot study of the statistical regularities of the quantitative distribution of atherosclerotic plaques in the arteries of the heart from data of selective radiopaque angiography are presented. The study uses an original angiographic classification of the arteries of the heart, as well as a method for determining the relative volume of atherosclerotic plaques in the arterial channel by the ratio of total volumes of arteries of the heart and atherosclerotic plaques in them. The method allows to conduct adequate standardized comparisons of the individual quantitative expression of atherosclerosis in the arterial channel of the heart irrespective of the features of the vascular anatomy and the distribution pattern of atherosclerotic plaques. It was established that the total volume of the arterial channel of the heart does not depend on the total number of arterial branches or on the anatomical type of the channel. In 41% of cases, the left type of coronary circulation is registered with exceeding the mean diameter of the left coronary artery in relation to the right by more than 30%. In other cases, the coronary circulation is balanced; most often atherosclerotic plaques are localized in the linear sections of the arteries, the frequency of the plaques location in the bifurcation segments is only 27%.

The experience of conducting a comprehensive tactical and special training session on working out the issues of organizing the work of mobile sanitary epidemiological and toxic-radiological groups in the field is presented. Its main goals were to improve the skills of the work of the personnel of mobile groups and identify problems in organizing the fulfillment of tasks in the event of emergencies of natural and man-made nature. At the first stage of the exercise, the mobile groups were readied for readiness to work as intended, at the second stage - the nomination to the designated area and the deployment of functional units in the field, at the third stage the selection and delivery of samples of environmental objects, sanitary-microbiological and toxic-radiological research. The conducted tactical-special occupation promoted the study of urgent issues of mobile sanitary epidemiological and toxic-radiological groups, and the ways of their solution. The productivity and the need for periodic holding of such classes are shown.

Some data summarizing the results of joint studies on the mechanisms of adaptation of the human body to hypoxia and local cold effects are given in the work. More than 170 volunteers - cadets of the S.M.Kirov Military Medical Academy and the Military Institute of Physical Culture. Possible connections in the processes of adaptation of the human body to cold and hypoxia, as well as the influence of interval hypoxic training on them, are considered. The effectiveness of preventive hypoxic training to increase the resistance of the human body to hypoxic hypoxia is shown.

Today, for the development of these qualities have pilots use different training methods: exercise on the stand «Statoergometr», which is the pilot’s seat with mechanical system to create static muscular effort feet; exercises power simulators that allow you to affect the necessary muscle groups; set of strength exercises with gymnastic equipment, which is recommended by the Manual on physical training in the Armed Forces. In addition, in accordance with the program of scientific research, we have developed a training methodology for the development of special power capacity pilots maneuvering aircraft, which does not require the use of any stands, simulators and other aids and appliances.

Modern features and prospects for the development of the Armed Forces determine the variety of tasks to be performed by the medical service in providing high-quality medical care to the wounded, sick and injured, which necessitates a wide range of technical means, primarily necessary for equipping the military unit. These samples of medical equipment are subject to increased requirements for reliability and resistance to the impact of the means of destruction and unfavorable environmental factors. The main problems that need to be resolved are: the development of technology; financing the development of new technical means; organization of serial production and purchase of new samples of medical equipment; qualitative development of modern samples of medical equipment by end users; сoordination of interaction between military authorities, scientific research organizations and industrial enterprises in the development, supply to supply and organization of supplying troops with new samples of technical means of the medical service. The solution of the set tasks is impossible without the joint work of all the participants in the process within the framework of the state arms program and based on a development strategy for the future.

In 13 young patients, the clinical features of community-acquired viral-bacterial pneumonia complicating the course of influenza A/H1N1 have been studied. For pneumonia associated with the influenza A/H1N1 virus, the prevalence of symptoms of general intoxication (headache), a low-productivity cough (in the presence of sputum-with a hemorrhagic component), a meager physical symptomatology are characteristic in the clinical picture. Among the laboratory indicators, the normal number of leukocytes in the general analysis of blood upon admission, a tendency to lymphocytosis, and a low level of C-reactive protein were noted. The appointment of adequate etiotropic antiviral therapy (oseltamivir 150 mg/day) provides a favorable outcome of community-acquired pneumonia, which develops in patients with influenza A/H1N1.

In November 2017, branch N 4 of FGKU «428th military hospital» of the Ministry of Defense of the Russian Federation in Ulyanovsk celebrated its 80th anniversary. Having started its history as an infirmary of the cadet corps at the beginning of the 20th century, during the Great Patriotic War the institution was already a full-fledged military hospital. Later, both the military personnel of the local garrison and the soldiers, who were wounded in the local armed conflicts of the late 20th century, were returned to service there. At the turn of XX and XXI centuries, the hospital was updated and expanded, the introduction of modern medical technologies and equipment became a great help to doctors. Currently, the hospital’s area of responsibility has increased significantly; capturing the Ulyanovsk region, the republics of Chuvashia, Mordovia, Mari El and the republic of Tatarstan, and the contingent has increased significantly. Due to this, the importance of the work of medical specialists of the Ulyanovsk hospital cannot be overestimated.

The article is dedicated to the round table «Medical robotics in the Armed Forces of the Russian Federation - topical issues development and application», which was held on August 24, 2017 in the framework of the scientific-business program of the International Military-Technical Forum «Army-2017». In the event actively participated representatives of the Ministry of Defense of the Russian Federation, the Ministry of Health of the Russian Federation Russia, Federal Agency for Scientific Organizations, and leading universities and research institutes in the field of medical robotics, practical doctors, who have extensive experience in the use of robotics and mechatronic medical equipment, representatives of industry, public organizations and the press. At the round table, scientific reports were devoted to the prospects for the creation and application of medical robotic complexes in the interests of the medical service of the Armed Forces of the Russian Federation, scientific achievements and scientific and practical research on topical issues of medical robotics and mechatronics.