Vol 344, No 5 (2023)

An analysis of mental disorders that occur in servicemen with adaptation disorders is presented. A study of the syndromic structure, anamnestic and follow-up information showed that the current diagnostic criteria for ICD-10 do not always allow an accurate diagnosis for adjustment disorders in military personnel. It has been established that the use of psychometric scales does not improve the accuracy of diagnostic conclusions. To develop proposals for improving the quality of diagnosis and prognosis in adjustment disorders, a structural-dynamic analysis and a level assessment of the characteristics of adjustment disorders were carried out in 1050 servicemen who received treatment in psychiatric hospitals of military medical organizations for various forms of adjustment disorders, their differential diagnostic and prognostic characteristics were determined. New fundamental approaches have been developed to optimize the diagnosis of adjustment disorders in servicemen.

Existing radioprotective drugs have serious side effects. Ligands of toll-like receptors (TLRs), which are the one of the primary pattern-recognizing receptors of innate immunity, are considered potentially useful compounds for reducing the toxic effects of radiation exposure. On cell cultures, the radioprotective activity of TLR2, TLR5, or TLR9 receptor agonists has been shown, in particular, the suppression of radiation-induced apoptosis and an increase in cell viability. The drug CBLB502 (TLR5 ligand) contributed to the bone marrow protection and intestinal epithelial cells after irradiation of mice and rhesus monkeys. Activation of TLR4 by its ligand, lipopolysaccharide, reduces bone marrow damage and increases the survival rate of mice. The most promising anti-radiation drugs are agonists of several TLRs – the TLR2/6 co-agonist drug CBLB613 and TLR2/6/4 receptor co-agonists beta-D-glucans. The data on the scientific literature indicate the promise of using TLR ligands as a basis for the new anti-radiation agents development.

A pulmonary tuberculoma is a clinical form of tuberculosis, in which a caseous-necrotic formation with a diameter of more than 12 mm has formed in the lung tissue under the influence of a chronic tuberculous process, delimited from the adjacent lung tissue by a two-layer capsule. The lack of a full-fledged blood supply, which prevents effective specific therapy, necessitates the prompt removal of pulmonary tuberculoma, and the presence of viable and virulent strains of Mycobacterium tuberculosis in the caseous contents necessitates the use of specific chemotherapy in the pre-and postoperative periods.

The influence of various factors on the risk of developing acute kidney injury in myocardial infarction in military men was assessed to improve prevention opportunities. The study included 502 patients under 60 years of age with verified type I myocardial infarction, 12 (2.4%) of whom were diagnosed with acute kidney injury. The following factors had a significant impact on the risk of developing acute kidney injury: unstable angina pectoris, arterial hypertension with a crisis course with a frequency of hypertensive crises more than once a month, no history of excess body weight, heart rate less than 64 per minute, left ventricular myocardial mass index 158.2 g/m2 or more, its ejection fraction is 60.6% or more, stroke volume is 79.4 ml or more, its late filling rate in diastole is 0.8 cm/s or more, total pulmonary resistance is less than 290.1 dyne×s×cm-5, serum sodium level 144 mmol/l and more in the first hours of the disease. Combinations of these factors show the risk of developing acute kidney injury in military personnel with myocardial infarction, which must be considered preventing this complication.

The association of polymorphisms of 8 different genes with the pathology of the nervous and cardiovascular systems of military personnel serving in the Arctic zone was studied. It has been shown that military personnel with the G/G genotype (G/A polymorphism – rs6265 in the brain-derived neurotrophic factor BDNF gene) in combination with the C/C genotype (T/C polymorphism – rs2043085 of the LIPC gene) are recommended for service in the Arctic belt. Ceteris paribus, it is preferable that the genotype of officers serving in the Arctic zone be G/G for the BDNF gene and C/C for the LIPC gene (rs6265 and rs2043085 polymorphisms, respectively). From a prognostic point of view, the selection criteria for military personnel by genotypes will increase the combat capabilities of groupings of troops (forces) in the Arctic zone of Russia.

In military medical organizations, various automated accounting systems are used to maintain material records of medical property, which are often not compatible with accounting systems. In the current situation, it becomes difficult to quickly collect information and report on the medical property. There is a lack of communication not only between medical supply units and accounting departments within the organization, but also between military medical organizations and military command and control. This paper highlights these problems and suggests ways to unify software products and include them in a single communication system.

The new colonic anastomosis technique takes advantage of the hardware and continuous single-row suture. After mobilization of the intestine, the anastomosed areas at the level of the planned resection are placed with the mesenteric edges to each other in the form of a double-barreled gun. Sutured in the middle of the distance between the mesenteric and antimesenteric edges on both sides, evenly stretched over the ligatures in the transverse direction. The formation of the posterior lip of the anastomosis occurs by simultaneous stitching of all four walls of the intestine with the imposition of a hardware suture with a U0-60 device and subsequent cutting off of the intestinal section. Moving away from the posterior lip of the anastomosis, all layers of the anterior walls of the intestines are dissected at a distance equal to 0.8–0.95 of its width. The anterior lip is formed with a twisted single-row continuous serous-muscular-submucosal suture using atraumatic absorbable synthetic suture material 4/0 with the immersion of the corners of the hardware suture. The creation of a combined colonic anastomosis greatly simplifies the operation, reduces its time while maintaining sufficient efficiency.

The history of the Main Center for State Sanitary and Epidemiological Surveillance (special purpose) of the Ministry of Defense of the Russian Federation is described. The stages of development of the organization are given. It is shown that over the 50 years of its existence, the specialists of the center have made a significant contribution to the preservation and strengthening of the health of military personnel. The main achievements of the team and its most prominent representatives are presented. The actual directions of the center’s activity at the present stage are demonstrated.