Vol 341, No 1 (2020)

In the current military conflict, among those killed on the battlefield, more than 90% of the wounded die from bleeding, 2/3 of which - from internal bleeding, which can only be stopped with surgical assistance. Moreover, the terms of evacuation of the wounded can reach 4-6 hours or more. Mortality reduction can be achieved by: accelerating the evacuation of the wounded; the use of systemic and local hemostatic agents; the creation of mobile surgical groups and their extension as close as possible to the battle zone. The article discusses the purpose and composition of the autonomous surgical group, its approximate equipment and deployment procedure. The main task of the unit should be the implementation of life-saving surgical interventions in the area close to the line of combat with such a view as to provide surgical assistance 30 minutes after the injury. The recommended list of performed surgical aids, possible problems in the organization of work and ways to solve them are presented.

Since the spleen takes the second place after the liver in terms of the frequency of injury, forensic experts often encounter injuries of this organ both in the study of corpses and in the examination of living persons. In the literature there is a large amount of scientific data relating to the establishment of the mechanism of formation of spleen injury. At the same time, there are no data in the scientific literature on the mechanism of formation of damage to the spleen with the tangential direction of the traumatic effect (oblique impact). In the present study, the method of finite element analysis of the distribution of deformations and stresses on the surfaces of the spleen was used to predict the destruction of the spleen tissue characteristic of perpendicular and oblique shock effects. The obtained data can be used in practice by forensic experts in deciding on the direction of the traumatic effect in a closed blunt spleen injury.

The aim of this work is to increase the efficiency of rehabilitation of patients with diabetic angiopathy through the combined use of therapeutic exercises, training walking and functional electrical stimulation of the muscles of the lower extremities. An examination and treatment of 90 patients with a diagnosis of type 2 diabetes mellitus complicated by angiopathy of the lower extremities, with a disease duration of at least 2 years, was carried out. Patients divided into 3 groups, comparable in age, gender and main clinical manifestations, were prescribed generally accepted basic drug therapy, diet, exercise therapy in the form of physiotherapy and training walking on a treadmill. Additionally, patients of the main groups after therapeutic exercises before training walking underwent functional electrical stimulation of the lower extremities using a pulsed bipolar current with a frequency of 10-30 Hz in the 1st group and 80-100 Hz in the 2nd group. It was revealed that the inclusion of functional electrical stimulation in the treatment complex contributes to a more effective regression of pain, a decrease in the manifestations of functional hemodynamic insufficiency. The most significant changes in clinical and functional parameters were achieved in patients during electrical stimulation with a frequency of 10 to 30 Hz.

Modern chemical threats that exist after the elimination of stockpiles of chemical weapons actualize research on the search for means and methods of counteracting them, increase the importance of using the latter in practice. This determines the role of military toxicology as an independent system of military-applied knowledge, the formation and implementation of which form the basis of the readiness of the medical service to counteract chemical factors, ensure the effectiveness of solving the tasks of preserving the life of military personnel and maintaining the combat readiness of troops. Based on the analysis of these threats and considering the experience of creating medical protective equipment, the article shows the unresolved problems of military toxicology, identifies promising areas of research to improve the means and methods of preserving the life of military personnel under the influence of chemical damaging factors. The tasks of the medical service for indicating rapidly degrading toxicants and restoring the combat readiness of military personnel by using antidote, symptomatic and pathogenetic therapy are noted.

A clinical case of a rare chest injury accompanied by a bullet embolism in the cavity of the left ventricle is presented. The problems of preoperative diagnosis of penetrating wounds of the breast with the localization of foreign bodies in the projection of the heart are considered. The possibilities of providing highly qualified medical care in a multidisciplinary medical institution are shown.

The history of a military hospital (branch N 1 of the 428th military hospital of the Ministry of Defense of Russia) located in the city of Saratov is described. Today it is a modern multidisciplinary military medical institution, deployed in more than 100 beds, where specialized and qualified medical assistance is provided.

The article talks about the history and today of the health resort «Divnomorskoe». The history of the formation and development of a military health resort from the moment of its creation is described. Data on the work of the institution in different years in the interests of improving health resort treatment and rehabilitation of military personnel, pensioners of the Ministry of Defense, and their families are given.