Vol 343, No 7 (2022)

The relevance of introducing modern technologies for managing military hospitals is determined by the need to increase the efficiency of their activities without increasing public funding. Under these conditions, the achievement of target indicators, including the quality and safety of medical activities, is possible by improving program-targeted planning and activities project management. The main characteristics of the project activity are given. Attention is focused on the use of a project approach to solving problems in the most important areas of the organization’s activities. As a specific example of a successfully implemented project, the creation of a level 1 regional trauma center based on a hospital, designed to provide medical care to victims of road traffic accidents, is given. As a result of the introduction of new technologies and the implementation of the necessary management decisions, mortality in patients from 2018 to 2020 decreased annually by 1.8–2.3%, and in 2021 amounted to 11.5%, with a predicted rate of more than 30%.

Within the planned ultrasound examination of the thyroid gland during the clinical examination, an assessment was made of the detection of extrathyroid formations, correlated by topography with a probable lesion of the parathyroid glands, in 778 men (age 65.30±19.54 years) and 556 women (67.55±11.03 years). In 10 and 11 patients (1.72% of all examined), focal changes were visualized in interest (without significant gender differences, p=0.75) – variants of the echographic picture: a classic formation occupying the entire volume (n=12; dimensions 12.2±6.06 mm) or a part (n=8; 5.1±1.52 mm) of the parathyroid gland (p=0.0048), as well as «mimicry» of the affected organ (n=4; 6.83±1.47 mm). When compared with the results of laboratory data (concentration of parathyroid hormone/total calcium), the relationship was determined arbitrarily in ¹/₃ of the cases. The rest showed «dissociation» between the methods of correlation (r=0). Despite the high resolution of ultrasound examination in determining focal changes located paratracheally and paraesophageally at the poles of the thyroid gland, a targeted search for changes in the parathyroid glands during a planned ultrasound examination of the thyroid gland is inappropriate both because of the ambiguity of the data got in the diagnosis of hyperparathyroidism, and distracting the attention of a specialist from paramount task.

The study included 885 patients. According to the results on the second day of hospitalization, all patients were divided into two groups: patients with a negative PCR test result in the presence of clinical signs of coronavirus infection (group I, n=410) and patients with a positive PCR test result (group II, n=475). Initially, there were no differences between the groups in terms of severity, main clinical manifestations and the course of the disease at the time of hospitalization, during treatment, and at the time of discharge. The treatment success rate was 83.9%, relative to mortality – 96.6%. Based on the data received, there were no statistically significant differences in the results of treatment depending on the prescription of various types of specific antiviral therapy in patients with a new coronavirus infection regarding mortality and the development of complications.

Based on the analysis of materials on the deployment of a special-purpose medical detachment in real conditions, it was established that with the existing norms of therapeutic nutrition, as well as because of the lack of the technological equipment, it is impossible to organize therapeutic (sparing) nutrition in the detachment. It is necessary to clarify the standards and equip these detachments with new mobile field technical means for preparing, transporting, storing and eating food. A variant of an autonomous mobile food station is considered, the composition and the chosen layout of which make it possible to improve the organization of medical nutrition, provide the possibility of convenient to work with the equipment. The van body of the mobile station is equipped with technical systems and a life support system, electrical equipment, and fire extinguishing equipment. It is proposed to expand the list of technical means necessary for the preparation and implementation of therapeutic diets, including technological equipment, means for transporting, storing and eating food. The importance of scientific developments on the problem of organizing therapeutic nutrition at the stages of medical evacuation and preparing proposals for including parenteral nutrition preparations in the list of medicines and tube feeding agents in the therapeutic rations, was noted.

The purpose of the study is to assess the capabilities of the freelance mobile storage department of the center for providing medical equipment and property to provide troops outside the points of permanent deployment. The study is based on the results of the Vostok-2018 and Zapad-2021 exercises to develop practical skills in medical supply planning, resupply of individual medical battalions and companies from the center for providing medical equipment and property, conducting preparatory measures and delivering medical equipment to the final recipient. It is concluded that it is necessary to maintain mobile units in the states of the center under study, as well as the center of pharmacy and medical equipment, in order to increase efficiency in carrying out tasks for their intended purpose in peacetime and wartime. Options for replenishing the stocks of medical property of medical supply units of formations and military units using a freelance mobile department of the center for providing medical equipment and property are proposed. Authors have developed proposals to improve the organizational and staffing structure of the center.

Amiodarone is the drug of choice to treat most types of arrhythmias. Taking the drug sometimes has a significant effect on the function of the thyroid gland, causing the development of amiodarone-induced thyroid disorders, including hypothyroidism. According to the study, amiodarone-induced hypothyroidism developed in 26.1% of all thyroid disorders within 14.2±1.5 months from the start of the drug. Most often, it was diagnosed with overweight individuals who received intravenous administration of the drug over 2 times a year, with a long history of thyroid disease.

The article describes a technique for restoring spontaneous urination in patients with chronic urinary retention and the presence of contraindications for surgical treatment. Mechanical stretching of the narrowed portion of the urethra using balloon dilation is applied. The advantage of the technique is its relative simplicity, low invasiveness, and absence of complications. Balloon dilation works well with bougienage and allows for longer intervals between these procedures.

The experience of the combined use of transcranial exposure to a running magnetic field and balneotherapy with hydrogen sulfide waters for the treatment of women in the gynecological department of the sanatorium is presented. The potentiation of the therapeutic effect of these factors is noted, which is expressed in increasing the effectiveness of therapy and reducing the time to reach the results of the sanatorium-resort treatment of dyshormonal diseases of the female reproductive system and contributes to the restoration of women’s social health.

The great surgeon Ernst Bergmann (1836–1907) – the founder of asepsis and the author of classical works, the Russian scientist, head of the surgical department in Dorpat until the end of the 1870s. This article analyzes Bergmann’s publications in the Military Medical Journal. Of great interest are his «Military Surgical Aphorisms», written as a report on the results of work on the battlefields of the Austro-Prussian-Italian War of 1866 and published in 1867. As a military doctor of the Russian army, Bergmann took part in the Franco-Prussian War of 1870–1871 and the Russian-Turkish war of 1877–1878, published articles about this in the Military Medical Journal. Subsequently, Bergmann’s publications in German scientific journals more than once became the subject of reviews on the pages of the Military Medical Journal.

In 1918, under the conditions of military communism, the Civil War and intervention in the RSFSR, the creation of a system of free dental care began, but the deployment of a network of state outpatient clinics was difficult because of a catastrophic shortage of trained specialists, equipment, materials and medicines. In 1918–1919, three waves of military mobilization of dentists took place, because of which almost all men under the age of 50 and women under the age of 40 were called up for military service. This made it possible to organize dental care in the Red Army. Because of the lack of material resources, it was difficult to create new dental offices and outpatient clinics, so a significant part of the mobilized dentists did not work in their specialty, but were used as paramedics, while the civilian population suffered from a shortage of dentistry specialists. Army allowances helped dentists who were in military service to survive the difficult post-revolutionary years. The article, based on archival data, analyzes the results of the military mobilization of dentists during the Civil War of 1917–1922.

The article presents a brief report on the All-Russian Interdepartmental Scientific and Practical Conference «Applied Issues of Military Medicine» held in September 2021 based on the State Complex «Palace of Congresses» of the Administration of the President of the Russian Federation. In the format of thematic sections, plenary sessions were held on the use of new technologies in the medical support of military contingents and applied aspects of toxinology. The event was timed to coincide with several memorable dates of the State Research and Testing Institute of Military Medicine of the Ministry of Defense of the Russian Federation, which required a separate consideration and analysis of the accumulated experience. So, in 2020, 5 years have passed since the resumption of independent work of the institute and the appearance of a research and testing center (applied research and field tests) in its composition. The research and testing center (of military medicine and military medical equipment), which is the successor of the Military Sanitary Institute of the Red Army, established in 1930, celebrated its 90th anniversary.