Vol 342, No 10 (2021)

The results of the analysis of the organization of medical support for law enforcement agencies are presented. The system of medical support formed in the law enforcement agencies makes it possible to successfully solve the tasks of preserving and strengthening the health of military personnel – a factor that has a direct impact on ensuring the combat readiness of formations, military units, and organizations of the Armed Forces, other troops, military formations, and bodies. The main directions of improving medical support for law enforcement agencies, which are currently being implemented and planned for implementation, are reflected, the purpose of which is to increase the efficiency of the functioning of the entire system as a whole and its individual elements.

The mid-term clinical, functional, and structural results of surgical treatment of servicemen with a full-thickness rupture of the rotator cuff of the shoulder joint were evaluated in 2 groups: in the 1st (n=30), treatment was performed using the single-row suture technique, in the 2nd (n=30) – according to the technique double-row seam with or without the installation of a balloon spacer. The functional results were assessed using the ASES and UCLA scales, and the structural integrity of the reconstructed tendon was assessed on postoperative MRI in 5 categories. The postoperative assessment was performed 12–16 months after surgery. The average UCLA score increased significantly from 17.9 to 31.2 in the 1st group and from 18.3 to 32.3 in the 2nd, according to the ASES scale – from 44.9 to 89.2 in the 1st group. 1st and from 42.5 to 92.1 in the 2nd. Assessment of postoperative MRI by H.Sugaya types revealed type I in 6 patients (20%) in group 1, type II – in 5 (16.7%), III – in 10 (33.3%), IV– in 4 patients (13.3%), V – in 5 patients (16.7%), in the 2nd group – type I – in 11 (36.7%), II – in 8 (26.7%), III – in 8 (26.7%), IV – in 3 (10%), V– was not found. Comparison of the mid-term clinical and functional results did not reveal significant differences between the single-row and double-row suture techniques. Comparison of the structural integrity of the reconstructed tendon showed the undeniable advantages of the double-row suture technique.

The analysis of the use of endoscopic methods of surgical treatment of patients with purulent-destructive lesions of the lungs and pleura against the background and after covid-associated pneumonia is presented. The experience of treating 61 patients with various forms of purulent-destructive complications of viral (COVID-19) pneumonia was analyzed. Particular attention is paid to the use of videothoracoscopy at the early stages of the onset of postcoid pleuropulmonary complications. Surgical tactics using minimally invasive videothoracoscopic methods of treatment allows to achieve earlier cleansing and sanitation of the pleural and intrapulmonary cavities, which, accordingly, leads to an earlier and successful restoration of the patient’s health and a reduction in the patient’s stay in the hospital.

In the article, military medical expertise is considered as a type of labor activity, which, depending on the purposes of its implementation, has significant differences in the methodology and labor functions of doctors of military medical commissions. The results of an empirical study of the professional characteristics of doctors performing military medical expertise are presented. A comparative analysis of the labor functions and competencies of specialists of military medical commissions carrying out medical examinations of citizens as the main type of activity, and clinical doctors conducting military medical examination as an addition to their professional duties is carried out. The significant specific labor functions of doctors of military medical commissions have been established. The conclusion is made about the need to standardize their activities.

The new coronavirus infection SARS-Cov-2 (COVID-19) has become a serious test not only for the civil health care of Russia but also for the medical service of the Armed Forces of the Russian Federation, which from the first days of the pandemic took the leading positions in treatment, medical rehabilitation, and prevention the spread of this deadly disease. The article reveals the features of the application of the principles of providing troops (forces) with medical equipment under conditions of restrictions due to the consequences of the spread of COVID-19. Specific examples show how the implementation of these principles contributes to the full and uninterrupted provision of formations and military units, military medical organizations with modern medical products, and effective medicines.

Based on the analysis of 182 patient case histories (April 2020 – April 2021), the article estimated the incidence of COVID-19 in children. Moderate course prevailed in boys, the frequency of its cases in the first wave (43%) was higher than in the second (10%), as well as the frequency of pneumonia – 12 and 3%, respectively. 100% of cases of pneumonia were observed in males.

The organization and methods of psychotherapeutic assistance in the military sanatorium are described. Analyzed for 2015–2017 structure of patients who received such assistance, in which patients (over 60%) predominate with hypochondriacal neurotic reactions, neurasthenia, anxiety and depressive disorders in combination with somatic pathology, patients with diseases of the cardiovascular system, autonomic disorders, prone to anxiety depressed (25–30%), patients with metabolic disorders (5–7%). The high effectiveness of psychotherapy in the course of medical and psychological rehabilitation of military personnel of special units has been shown: in 99–100% of cases there is a significant improvement in health and an objective removal of the symptoms of fatigue and asthenia.

In 2021, the first Russian state inpatient medical institution – the N.N.Burdenko Main Military Clinical Hospital – celebrated the 315th anniversary of its foundation. The hospital was founded in 1706 by the decree of Peter I in Moscow, near the location of the Lefortovo regiment, and began work in 1707. The hospital school began training the first domestic doctors, the treatment of patients was combined with training, thereby laying the foundations of Russian clinical medicine. Over the centuries, with the talent and work of the team, these traditions have been creatively developed, the medical and scientific potential has increased, the technique and equipment have been improved, but the readiness to serve the Motherland and the defenders of the Fatherland, and the high professionalism of the employees have remained unchanged. Wars and local conflicts with the use of more and more sophisticated types of weapons, epidemics, destructive natural disasters, and man-made disasters require constant improvement of assistance to the wounded and injured, therefore the readiness of the N.N.Burdenko Main Military Clinical Hospital to provide high-quality medical care should always be constant.

The authors of the article have identified in state archives, private collections and for the first time introduced into scientific circulation new facts about the biography of the professor of the Imperial Military Medical Academy V.N.Sirotinin (1855–1934) – the most eminent and prominent therapist of Russia in the early 20th century, the leader of the therapeutic clinics of that time. The study made it possible to clarify some unclear, contradictory information regarding his life, work activity, and creative achievements. The article analyzes the materials about V.N.Sirotinin revealed in the archives. It is noted that only in the 21st century has come for him to return to a place of honor in Russian medicine history.

On April 14–15, 2021, a scientific and practical conference «Aerospace medicine, aviation psychology, and military ergonomics. Formation, state and development prospects», was dedicated to the 60th anniversary of Yu.A.Gagarin’s space flight. On the first day of the conference, 11 heads of the leading institutions of the Ministry of Defense, the Ministry of Health, and the space industry spoke, who noted the historical role of the State Research and Testing Institute of Aviation and Space Medicine in the formation and development of manned astronautics, the preparation of the 1st cosmonaut corps and the provision of Yu.A.Gagarin. On the second day of the conference, 19 reports on topical problems of aerospace medicine, aviation psychology, and military ergonomics were heard and discussed. The participants of the conference got acquainted with the laboratory and bench base of the Scientific Research Center of AKMVE and its latest developments.