Vol 345, No 1 (2024)

The results of an analysis of the medical service activities of the Armed Forces in 2023 in its main areas are presented. Particular attention is paid to the organization of medical care and treatment of the wounded during a special military operation. The multi-level system of staged medical care has proven its effectiveness. The following results were achieved: the time for providing first aid was reduced by 3 times (to 10 minutes), providing medical care to a serviceman from the moment of injury – by 2 times (to 1 hour); 98% of military personnel were discharged upon recovery after treatment for wounds and injuries; mortality at the stages of medical care was 0.43%, disability – 2.1%. First aid training for personnel resulted in a potentially preventable mortality rate of 5.2%. The main task facing the medical service in 2024 will be the timely and high-quality provision of medical care to the wounded and sick when performing tasks in a special military operation. Work will continue to summarize and analyze the experience of the participation of medical services in the special military operation and improve the system of medical care at all stages, reduce the level of diseases relevant to troops, introduce new high-tech methods of providing medical care and laboratory diagnostics; increase the volume and quality of rehabilitation measures for military personnel, supplying modern medical equipment and medicines to military units and military medical organizations not lower than 90% of the need; maintaining a stable sanitary and epidemiological situation.

The presence of metal fragments (wounding projectiles) in the tissues of blind gunshot wounds significantly affects the course of the wound process, often prolonging regeneration, maintaining inflammation, increasing the risk of developing purulent-septic complications, bedsores on the walls of the great vessels with fatal bleeding and the development of other pathologies. The experience of 96 cases of using neodymium magnets to search and extract foreign bodies (fragments) during surgical treatment of gunshot and mine blast wounds in military personnel delivered from the zone of a special military operation is summarized.

The feasibility of prescribing anticoagulants and the role of prolonged anticoagulant therapy in the period after discharge from hospital currently remain incompletely studied. From December 2020 to December 2021, dynamic monitoring of patients who had COVID-19 was carried out. The number of confirmed cases of pulmonary embolism, deep and superficial vein thrombosis, and major bleeding within 30 days after discharge was determined. There were 2 cases of pulmonary embolism, 4 cases of deep vein thrombosis of the leg according to color duplex scanning, 6 cases (1.04%). There was no bleeding. The prescription of direct oral anticoagulants in prophylactic doses after COVID-19 is justified if indicated.

Whooping cough is currently a topical infection among the adult population, including military personnel. In various countries of the world in the last decade, a steady increase in the incidence of whooping cough and large outbreaks of the disease in military groups have been recorded. The current situation has contributed to the introduction of a number of programs for the revaccination of adults at risk (medical workers, military personnel, teachers, people with immunodeficiency processes, etc.). The article discusses the current data on whooping cough among military personnel and how it can be prevented by the medical service of the Russian Armed Forces.

A critical analysis of modern scientific and technological achievements in improving technical means for obtaining medical oxygen based on adsorption and other technologies, as well as determining the dominant trends in their development, was carried out. It has been established that most publications deal with the functioning of oxygen generators (concentrators) under various conditions. The most common solution to increase productivity is to replace the brand of zeolite with a lithium-containing zeolite, grinding it to nanoparticles. The development trends of technical means for obtaining medical oxygen are determined, which consist in the improvement of portable (wearable) generators (concentrators) suitable for military health care and disaster medicine service, and generators (concentrators) for operating units and intensive care units.

Congenital ductal changes, which are determined in the form of strictures and parotid ductal ectasia and submandibular salivary glands, occur in 70% of patients suffering from chronic sialadenitis. Analyzing the literature and archival data from the Department of Maxillofacial Surgery and Traumatology, the A.I.Evdokimov Moscow State Medical and Dental University, the authors noted the absence of long-term remission in patients with severe ductal ectasia of the submandibular salivary glands with only conservative therapy. A surgical treatment method was proposed, which provided a low level of trauma to collateral tissues and a stable long-term result. In 98% of patients after surgery, clear secretion was detected in sufficient quantities, without signs of inflammation, and the symptom of “salivary colic” was absent.

The advantage of using local vibration therapy of the upper urinary tract over traditional treatment methods has been confirmed. A higher lithokinetic effect of amplipulse therapy was revealed compared to traditional conservative therapy – stone passage was observed on days 8–10 from the start of treatment. The most promising should be considered the use of vibration stimulation of the urinary tract in patients with stones of the lower third of the ureter, including after shock wave lithotripsy.

The results of treatment in the regular medical rehabilitation department of 320 patients who had suffered COVID-19, who made up the experimental group, are presented. Comprehensive rehabilitation included psychodiagnostics (testing), psychotherapeutic conversation, individually targeted acupuncture sessions, medical leech therapy (hirudotherapy), intravenous laser blood irradiation, ozone therapy and apitherapy. A subgroup of 114 people did not receive apitherapy. The control group consisted of 437 patients who refused treatment in the medical rehabilitation department. It was revealed that in the experimental group the results of rehabilitation were higher, while the use of apitherapy made it possible in a larger number of patients to reduce the manifestations of astheno-vegetative syndrome, normalize blood pressure and reduce the risk of thrombosis.

The article is devoted to the personality and memories of the chief surgeon of the N.N.Burdenko Main Military Clinical Hospital (during the Great Patriotic War – head of the II Faculty of the S.M.Kirov Military Medical Academy, professor, major general of the medical service F.F.Beryozkin about his service during the Civil War in the ranks of the Red Army on the Soviet-Polish front. He had to take over the leadership of the hospital, while simultaneously providing surgical care to the wounded, and also find himself in the Polish captivity (1920–1921): for 15 months in the Strzhalkovo concentration camp, he supervised surgical work in the camp hospital. Thanks to his loyalty to the Motherland, military and medical duty, high humanism, courage and medical skill, thousands of lives of defenders of the Fatherland were saved.