Vol 343, No 11 (2022)

The purpose of the study is to evaluate the results of medical and psychological rehabilitation of military personnel using the potentiating effect of natural healing factors in combination with individual psychotherapy programs. The study was conducted by a continuous method: for the period 2017–2021, 1048 servicemen underwent medical and psychological rehabilitation. The combination of individual psychotherapeutic treatment and natural therapeutic factors in the treatment and rehabilitation program of military personnel not only allows solving several problems (treatment and prevention, correction and training of patients in self-regulation and self-development, personal mental hygiene), but also improves the quality of life, improves further psychosocial adaptation and self-realization. High clinical efficiency is confirmed by subjective (rehabilitators) and objective (functional and mental state) assessments.

The results of the analysis of literature data on the methods of diagnosis and treatment of patients with acute pancreatitis depending on the stage of the disease are presented. The diagnostic algorithm for patients with acute pancreatitis includes anamnestic data, the clinical picture of the disease, clinical and laboratory methods, instrumental non-invasive and invasive methods. The tactics of treatment is determined by pathological changes in the pancreas, parapancreatic and retroperitoneal tissue. Conservative treatment includes extracorporeal detoxification methods, endolymphatic and lymphotropic administration of antibacterial and immunotropic drugs, including ozone therapy. Options for modifying anti-inflammatory therapy and ways to increase its effectiveness are considered. Traditional pathogenetic treatment of patients with acute pancreatitis should be carried out with their immunorehabilitation, which necessarily includes immunotropic drugs. Modern instrumental diagnostic methods provide an opportunity for accurate topical diagnosis and the use of precision surgical interventions.

The aim of the study was to assess the severity of the course of a new coronavirus infection in vaccinated patients. The retrospective study included 116 patients who underwent outpatient treatment for COVID-19 from 10.01 to 10.02.2022. The average period between the introduction of the vaccine and the disease is 4.5 months, the age of patients is 23–55 years. The main diagnostic criteria were a positive PCR result for the presence of SARS-CoV-2, a general blood test (leukopenia, lymphopenia, thrombocytopenia). Some of the patients (71 people) were vaccinated with «Gam-COVID-Vac», 45 were revaccinated with «Gam-COVID-Vac». Vaccination prevents the severe course of COVID-19 (pneumonia, coagulopathy, inflammatory syndrome). The vaccinated patients had a mild course of the disease, there were no complications.

Long-term use of amiodarone sometimes contributes to the development of amiodarone-associated thyrotoxicosis. Allocate 1 and 2 types of this thyroidopathy. According to our study, amiodarone-induced thyrotoxicosis is detected in 57.9% of cases. Its type 1 is most often diagnosed, which often develops in patients with overweight, and is also characterized by more pronounced complaints, a significant clinical picture, and significant morphological and functional changes in the thyroid gland. In patients with type 2 amiodarone-induced thyrotoxicosis, there was a shorter period from the start of taking the drug to the development of clinical manifestations of thyroidopathy, laboratory changes in basal metabolism, as well as manifestations of damage to the cardiovascular system, were less pronounced.

In the practice of otorhinolaryngology, the diagnosis and treatment of olfactory disorders play an important role. In modern conditions, introducing new technologies, changes in the environment, the realities of the COVID-19 pandemic have led to the emergence of features of the occurrence, prevention and treatment of this pathology. The article summarizes current information about the anatomy and physiology of the human olfactory analyzer, pathogenesis, diagnosis and treatment of olfactory disorders. The features and difficulties in the work of otorhinolaryngologists and other specialists in helping patients with olfactory dysfunction are analyzed. The question of the possibilities of diagnosing and treating olfactory disorders in the COVID-19 pandemic is discussed. It is concluded that there is no convincing data on the pathogenesis of most olfactory disorders, and therefore the effectiveness of the correction of this pathology remains low, and this problem requires further study and solution.

The experience of conducting medical and psychological rehabilitation in the sanatorium «Paratunka» of military personnel from the crews of submarines is presented. To identify changes in psychophysiological parameters in submariners after a long sea voyage and the influence of various treatment methods on their recovery, an analysis of medical record data for 2019–2021 was carried out on patients diagnosed with overwork and obstructive sleep apnea syndrome. Additional examination methods were used to study physiological parameters. Changes in the psycho-physiological state, characteristic of military personnel of this category, have been established. Methods for eliminating the identified deviations are proposed for application besides the basic standards. A positive effect on the recovery of psychosomatic and laboratory parameters of CPAP therapy and the audiovisual psycho-correction program SANATA, used besides the standards for providing medical and psychological rehabilitation for military personnel of submarine crews, has been proven.

A decrease in visual acuity in servicemen of working age requires a comprehensive additional examination to clarify the nature of the disease. Among the causes is optic neuritis – a clinically isolated syndrome of multiple sclerosis – the earliest stage of the lesion. An analysis of a clinical case of a patient with optic neuritis of demyelinating etiology was carried out.

Based on the experience of the mammalogical department of the 9th Medical and Diagnostic Center of the Ministry of Defense of the Russian Federation, the results of the diagnosis and treatment of over 8 thousand patients with benign breast diseases are presented. The most rational schemes of diagnostic procedures are determined, the features of the «closed cycle» of diagnosis and treatment of this pathology are disclosed. The features of preoperative preparation of patients, performance of surgical interventions are shown. The organization of the «Women’s Health Center» as part of the treatment and diagnostic center makes it possible to provide high-quality specialized medical care to patients with breast disease and combined gynecological pathology.

The article describes the main stages of the formation and functioning of the Central Military Hospital of the Missile Forces – now branch No. 3 of the A.A.Vishnevsky National Medical Research Center for High Medical Technologies of the Ministry of Defense of the Russian Federation – from the moment of its creation in 1962 to present tense. Achievements in the treatment and diagnosis of various diseases and injuries are reflected, promising directions in the development of specialized (including high-tech) medical care are identified, the role of the team, which for sixty years has been contributing invaluably to the implementation of the medical and diagnostic process, scientific and research and teaching activities, as well as logistical support for the needs of the branch.

The article presents professional and biographical information about the activities of Major General of the Medical Service A.F.Golosov, the organizer of military health care, a scientist and teacher (1894–1955). After graduating from the medical faculty of Moscow University, A.F.Golosov since 1919 was in the military service in the Red Army, took part in the Civil War. He served in the army and medical institutions. In 1938, he was appointed a corps doctor, and in 1939, head of the sanitary department of the Kharkov military district. During the Great Patriotic War, he was the head of the sanitary department of the 18th Army of the Southern Front and the head of the sanitary department of the South Ural Military District. In the post-war period, he headed the department of military medical training at the Chkalovsky Medical Institute. Scientific works of A.F.Golosov are devoted to the organization of medical service in military formations, medical care for the sick and wounded in hospitals, the history of military medicine.

Based on the decision of the President of the Russian Federation to provide methodological and practical assistance to the Ministry of Defense of the Republic of Kazakhstan in the fight against a new coronavirus infection, in July 2020 a merged detachment of medical specialists from the Russian Ministry of Defense was formed. The squad included 2 groups of doctors, each of which included an anesthesiologist-resuscitator, a therapist, an infectious disease specialist. The main activities were the provision of specialized medical care to patients with a new coronavirus infection, conducting educational and methodological sessions with medical personnel of medical institutions of the Ministry of Defense of the Republic of Kazakhstan. Over 100 patients were provided with specialized medical care in the conditions of the «red zone», outpatient and advisory assistance was provided to over 50 patients with post-covid syndrome, over 20 educational and methodological sessions and lectures were held.