Vol 342, No 11 (2021)

The implementation of the program «Combating cardiovascular diseases in the Armed Forces of the Russian Federation», designed for the period from 2020 to 2024, is a timely and necessary step in reducing the incidence, dismissal, and mortality of military personnel from diseases of the circulatory system. The implementation of the program will lead in 2024 to a decrease in the mortality rate of servicemen from these diseases by 21.6% and by 20% in their dismissal rate. To achieve these indicators, measures are being taken to prevent diseases of the circulatory system and cardiovascular complications in high-risk patients, to ensure the quality of medical care, treatment, and rehabilitation of patients with cardiovascular pathology, to staff military medical organizations, and to re-equip them with medical equipment. The activities of the program, despite the pandemic of the new coronavirus infection, are being carried out on time and in full.

The study aimed to improve the performance indicators of military medical organizations of the 2nd level in the surgical treatment of patients with urolithiasis. The analysis of the incoming flow of patients with urolithiasis, the provision of medical equipment for military medical organizations of the second level, the correspondence of the organizational and staffing schedule to the volume and nature of the tasks performed is presented. An increase in hospitalizations was noted among servicemen under contract and conscription, a decrease – among the rest of the contingents. The decrease in operational activity was 10.4%. The material and technical capabilities for performing remote lithotripsy and endoscopic operations are available only in 11.8% of basic and 75% of district (naval) hospitals, percutaneous surgery – only in 25% of medical institutions of district subordination. The ways of improving the system of providing specialized medical care to patients with urolithiasis, the conceptual basis of which is the creation of regional urological centers based on all district hospitals and the main hospital of the Northern Fleet.

Purulent diseases of the hands and fingers are a complex problem that requires a systematic approach, the most important role in which is assigned to the stages of treatment depending on the stage of the wound process. Physicochemical properties of drainage and dressing materials in direct contact with the wound surface have a great influence on reparative processes. Currently, the process of wound drainage is achieved through the use of sorption dressings, hyperosmolar solutions or media, drainage proper, as well as combined methods. The question of the properties of materials used for dressing and drainage of purulent wounds and their effect on clinical outcomes remains promising for a solution.

The article presents the experience and modern principles of organizing the treatment and diagnostic process of a large departmental multidisciplinary medical institution for surgical complications of alcoholic cirrhosis of the liver. The innovative organizational and clinical solutions have been substantiated, which contributed to a decrease in mortality in this pathology. The main directions of further improvement of the practical activity of a military medical institution to improve the key indicators of therapy for alcoholic liver disease have been determined.

The research was conducted in 2020 at the clinic of the «Izmerov Research Institute of Occupational Health», which accepts patients with coronavirus infection for treatment. Indicators of the thermal state of the body of the observed individuals were evaluated during 5 hours of work following MUk 4.3.1895-04. For medical workers wearing COVID-19 PPE in the «contagious zone» after three hours of work, all indicators of the thermal state of workers corresponded to acceptable values. During the five hours of medical workers performing medical procedures and official duties in the studied PPE, there was an increase in almost all values of the indicators of the thermal state against the background of continuing profuse sweating.

Conclusions. Analysis of the dynamics of heat exchange indicators in the body of medical workers performing physical work with energy consumption of 179±73 W/m², dressed in biological PPE, including COVID-19, allowed us to determine the rate of change in their thermoregulatory reactions and revealed the permissible duration of work in the «contagious» zone – no more than three hours. To normalize the moisture on the surface of the skin of health workers in the «red» zone, it is necessary to Supplement the protective equipment used with special underwear (shirt, trousers, and headdress) made of light, moisture-absorbing materials with sufficient vapor permeability and hygroscopic, capable of absorbing and removing the released moisture with sweat from the surface of the human body. Without the use of special underwear made with the use of vapor-permeable membranes, complete with biological PPE, including after three hours of work in the «red» zone, medical personnel needs a break of up to 30 minutes in a room with comfortable microclimate parameters to fully restore the body’s thermal state without PPE from COVID-19.

To improve drug supply in the Armed Forces of the Russian Federation and monitor the quality of drugs, a digital transformation of the management of their resources, building a digital routing of drug supply through the rational integration of the necessary digital services that form a single digital circuit for providing a patient in the provision of all types of medical care is relevant. The «digital drug portrait of a patient» allows monitoring pharmacotherapy, digitalizing the choice of the treatment regimen, forecasting needs and managing procurement, optimizing the formation of reporting and application documentation, and, if necessary, integrating interaction with civil health authorities.

One of the oldest outpatient clinics, the 12th Consultative and Diagnostic Center of the Ministry of Defense of the Russian Federation, celebrates its 100th anniversary. The article reflects the main stages of the establishment and development of the institution, changes in the organizational and staff structure. The chronology of the opening of medical departments, offices, and support units is tracked. The types of medical care provided are presented, attention is paid to the leaders who ensured the progressive development of the institution from an outpatient clinic to a consultative and diagnostic center.

The scientific and practical contribution of military doctors, participants of the Great Patriotic War, major-generals of the medical service A.S.Gozulov, P.V.Vasiliev, and E.A.Karpov in aviation and space medicine is presented. Their great contribution to the long-term scientific and practical research of the State Research and Testing Institute of Aviation and Space Medicine of the USSR Ministry of Defense and the medical and biological support of flights of aviation and spacecraft is noted. The main content of the scientific activity of S.A.Gozulov was the problem of the impact of accelerations on the human body and emergency rescue of crew members of jet aircraft. P.V.Vasiliev is one of the founders of a new scientific direction – aviation and space pharmacology, who substantiated the reasoned and controlled use of pharmacological drugs in aerospace medicine. E.A.Karpov – the first head of the Yu.A.Gagarin Cosmonaut Training Center. It is noted that each of them in their field has shown an outstanding talent of a leader who can set a task, formulate a scientific problem and organize effective control of its solution, made a significant contribution to the development of selected problems, the creation, and improvement of the system of medical and biological support for flights of aircraft crews.

In St. Petersburg, based on the multidisciplinary clinic of the S.M.Kirov Military Medical Academy under the leadership of the chief urologist of the Ministry of Defense in May 2021, the All-Army Scientific and Practical Conference (gathering of urologists of the Ministry of Defense of the Russian Federation) «Topical issues of high-tech urological care in the military medical organizations». The conference was attended by the main specialists of urological centers and departments of hospitals of central subordination, district (naval) hospitals and their branches, chief urologists of the power structures of Russia (Ministry of Internal Affairs, Rosgvardia, and the Ministry of Emergency Situations), heads of specialized departments of medical universities and leading urologists of St. Petersburg, as well as faculty of the Department of Urology of VMedA, staff of its clinic and students of the Academy. The main directions of the provision of high-tech medical care in military urology, including the prospects for the active use of robot-assisted operations, were discussed. Thanks to the modern format of the conference, its participants got a unique opportunity to see in real-time the use of modern minimally invasive endoscopic and robotic technologies.