Vol 343, No 10 (2022)

The purpose of the study was to evaluate the effectiveness of the organization of medical rehabilitation in the clinical health-resort «Volga» of the Russian Ministry of Defense. The features of its implementation for military personnel, military pensioners, members of their families, as well as the adult population of the Samara region – in the system of compulsory medical insurance (since 2017 at the third stage, and since 2019 – at the second) are outlined. Since 2016, the health-resort has introduced modern technologies of physical and rehabilitation medicine into rehabilitation programs for the treatment of patients with various diseases, which has increased the number of patients in need of medical rehabilitation and significantly improved the effectiveness of rehabilitation measures. Work in the system of compulsory health insurance is promising both in terms of generating income for the institution (reducing the burden on the federal budget), and preventing idle bed funds (taking into account the pronounced seasonality, the efficiency of using the institution’s bed fund increases).

The article presents the results of a retrospective analysis of the organization of the work of operational groups for special processing during the COVID-19 pandemic. Measures for the disinfection of objects and equipment are presented as a single process aimed at increasing the efficiency of actions of operational groups for special processing and decision makers. The issues of increasing safety and reducing the psycho-traumatic impact during disinfection measures are highlighted. The need to improve the management system and the regulatory framework for disinfection measures is emphasized. An assessment of the effectiveness of disinfectants and technical means used by operational groups for special processing is given. The creation of a laboratory of molecular diagnostics based on the 27th Scientific Center of the Ministry of Defense of the Russian Federation made it possible to reduce the time for performing diagnostic measures and ensure the safety of personnel. The accumulated experience can be used in emergency situations of an epidemiological nature, including the elimination of the consequences of bioterror attacks using pathogens of especially dangerous infections.

For 115 patients (88 men, 27 women, average age is 59.3±10.5 years, hospitalized from September 14 to December 1, 2020 in a repurposed infectious diseases department for patients with a new coronavirus infection with a confirmed diagnosis of COVID-19), the relationship of initial clinical and laboratory parameters with the course of the disease and the association of the NLR, CALL, HNC-LL scales with its unfavorable character was assessed. The HNC-LL scale showed high sensitivity and specificity (73.2 and 68.3%, respectively). The CALL scales (sensitivity – 77.8%, specificity – 51.5%) and HNC-LL are effective in predicting the extremely severe course of COVID-19.

Arrhythmogenic cardiomyopathy is a rare myocardial pathology, which accounts for up to 20% of all causes of sudden cardiac death in the modern world. The wide prevalence of this nosology among young people with a high adherence to physical activity makes screening for arrhythmogenic cardiopathy as relevant as possible, since the prognosis for life directly depends on this. Diagnosis of arrhythmogenic cardiomyopathy is complex and requires an integrated approach, since there is no “golden” diagnostic method that could unambiguously confirm or exclude this diagnosis. The article presents a clinical observation of a 40-year-old man with recurrent syncope. The examination confirmed the classic right ventricular type of arrhythmogenic cardiomyopathy. An example of a diagnostic approach to proving a high risk of sudden cardiac death and treatment tactics is given.

A review of foreign and domestic scientific literature containing data on the frequency, pathogenesis and treatment of atrial fibrillation in coronavirus infection is presented. This topic was chosen because of its relevance, prevalence of morbidity and possible complications. A separate part of the publication is devoted to the study of the pathogenesis of arrhythmia during the period of the disease, the knowledge of which contributes to an integrated approach to therapy. The tactics of managing patients with atrial fibrillation during a coronavirus infection are considered.

The article considers the medical outcomes of 5 emergency exits of the Yak-130 aircraft (10 crew members), including 9 (90%) survived. Among the survived pilots, 77.8% had minor injuries, 22.2% had severe. All had multiple 2nd degree burns in the anterior chest, shoulder joints and forearms. Compression fractures of the thoracic vertebral bodies and concussion represent severe injuries. All injuries were received during ejection under off-design conditions (late emergency escape of the aircraft beyond the resolving capabilities of the ejection system and violation of the correct posture for ejection). Severe injuries resulted from a shock overload of the ejection seat energy sensor (under conditions of an incorrect pilot’s position) and a shock overload of landing on a parachute, and light injuries resulted from exposure to fragments of the SOAV pyrocord, which caused burns. In order to increase the injury safety of the emergency evacuation of the Yak-130 aircraft, it is necessary to resolve the use of thermal protective equipment by the crew members.

In 2022, the Military Medical Museum – the museum of Russian medicine and the military medical service – celebrates its 80th anniversary. The article refers to the rich history of the museum, analyzes its multifaceted activities and achievements at the present stage. The work on the preservation of the historical collections of the museum and the formation of new collections, reflecting the current state of domestic medicine and telling about the outstanding physicians of our time, is considered. The article also touches upon the role of the Military Medical Museum as a center of patriotic education and health education: the importance of the developed program of museum-patriotic education is shown, formats of work with different age groups, cadets and personnel are considered. Special attention is paid to the museum as a scientific and methodological center in cultural and patriotic work, museology for medical museums and museum formations.

The article is devoted to the contribution to the development of naval medicine of the head of the medical service of the Baltic Fleet in 1976–1983, colonel of the medical service I.S.Brykin, who would have turned 95 in July 2022. Constant analysis and generalization of the experience of the medical services of formations, fleet associations was the leitmotif of I.S.Brykin’s activity in the development and implementation of new forms and methods of medical support, the search for ways to increase the combat effectiveness of personnel. The methods and forms of organization of medical support introduced by him, as well as scientific developments on this topic, are used in practice by the medical service of the Baltic Fleet.