Vol 344, No 1 (2023)

In this article presented the analysis of Medical Service of the Russian Federation Armed Forces activities during the Special Military Operation and partial mobilization in 2022. Described priority activities for saving lives of servicemen, their health recovery and soonest possible return to active duty. Analyzed the dynamics of servicemen`s morbidity rates and results of sanitary-epidemiological (preventive) activities in troops. Presented results of comprehensive supply with all necessary medical equipment, additional professional training (retraining) of medical personnel. Determined peculiarities of scientific-research work and implementation of innovative achievements in military medicine`s practice. In military medical planning activities revealed the achieved decrease of primary morbidity rates, verified the necessity of further development of aeromedical evacuation system, formation of regulatory legal framework, improvement of logistical support. Formulated the primary objectives for 2023, based on experience of medical support gained during the Special Military Operation.

An important aspect in the provision of medical care to patients with acute chemical poisoning is the correct formulation of the toxicological diagnosis, which affects both the medical tactics during the treatment period and making an expert decision on the fact of a chemical injury during a medical examination. Insufficient knowledge about the features of establishing a toxicological diagnosis can lead to errors in preparing medical documentation, which drastically reduces the quality of medical care, especially when it is organized in numerous stages. For practical use, options for formulating diagnoses for poisoning and acute chemical poisoning at various stages of medical care, an expert diagnosis by a clinical toxicologist during a medical examination of a serviceman upon discharge from a military medical organization are given.

The article summarizes current literature data on the principles of staged treatment of combat injuries of the upper limbs with damage to the main vessels. The author analyzes his own experience in diagnosing and treating 54 wounded with injuries of the main arteries and veins of the hands at the first stage of specialized care in a basic medical institution. The provision of surgical care and the shortcomings of temporary arterial prosthetics at the stage of qualified medical care are considered. A set of diagnostic clinical and instrumental criteria for adequate detection of damage to the arteries of the subclavian-brachial segment is presented. The results got are compared with the conclusions of the literature sources. The optimal volume of specialized surgical care is discussed depending on the medical and tactical conditions in the base hospital. Examples of different surgical interventions on the main vessels of the upper limbs in case of their combat injuries are given.

The results of the analysis of the work of the surgical service of the branch of the central military hospital, redeveloped into a temporary infectious diseases center for 200 beds with departments of pulmonology, gastroenterology, neurosurgery, urology, emergency surgery, resuscitation for surgical patients, 2 operating units (for 6 operating tables) and 3 dressing rooms («red zone»). One surgical team of two-medical staff was always on standby. 97 patients with COVID-19 were operated on at the infectious diseases center, 108 surgical interventions, 761 dressings were performed. In addition, 115 patients received consultations from surgeons. 8 patients required re-operations. Thoracocentesis with drainage of the pleural cavity was performed more often (30.6%) in case of spontaneous pneumothorax. There were 2 (2.1%) deaths. The deployed temporary infection center has fulfilled its tasks of providing emergency surgical care to patients with COVID-19.

The diagnosis of prostate diseases (acute and chronic prostatitis, hyperplasia and prostate cancer) in the outpatient setting and their treatment at home was assessed. The study included 161 patients under the supervision of an urologist. The average age of patients is 82.2 years. Patients underwent general clinical and special urological examination (biological material was taken at home). Treatment was carried out under clinical guidelines. The result of therapy was assessed based on complaints, changes in clinical and laboratory parameters, IPSS and QoL data. It has been proven that transrectal ultrasound for the diagnosis of prostate diseases in patients with limited mobility is not mandatory. A high efficiency of outpatient diagnostics and treatment of prostate diseases at home in this category of patients has been achieved. Treatment at home reduces the number of outpatient care requests.

The present article describes the experience of developing technical and reagent tools for the specific indication of biopathogens over the past 15 years using the example of the created samples of a kit for point enzyme immunoassay, a wide-field luminescent field microscope, a set of reagents for detecting pathogens of dangerous vector-borne diseases of a viral and rickettsial nature using polymerase chain reaction in real-time mode and experimental production series of enzyme immunoassay test systems for point enzyme immunoassay. The positive results of state tests of prototypes and experimental production series of these funds made it possible to recommend them for acceptance for the supply of the Armed Forces of the Russian Federation and, basically, to introduce them into the practice of the military medical service. The analysis of the conducted studies made it possible to identify negative and positive experiences in the creation of such samples and develop recommendations that should be followed when creating various medical protective equipment.

The etiology, clinical manifestations, diagnostic criteria, differential diagnosis and treatment of progressive supranuclear palsy are considered. A clinical observation is presented, showing the importance of magnetic resonance imaging of the brain in differential diagnosis. This study made it possible, besides the signs characteristic of neurodegenerative diseases (diffuse atrophy of the brain, substitutive hydrocephalus), to reveal atrophy of the midbrain and pons according to the «hummingbird symptom» type, which is characteristic of supranuclear palsy.

The branch health-resort «Zvenigorodsky» celebrated its 75th anniversary last year. Created in the post-war years, the health resort has evolved from a health-resort-type rest home to a modern multidisciplinary health-resort with 600 beds. Today the health-resort provides its visitors not only with spa treatment but also with effective programs of medical and medical-psychological rehabilitation using modern equipment and new methods of rehabilitation treatment, including after a new coronavirus infection.