Vol 344, No 9 (2023)

The purpose of the study is to substantiate the directions for improving medical rehabilitation in the Southern Military District based on an analysis of the effectiveness of its programs. A positive trend has been established in the total number of those referred for medical rehabilitation — by 1.9 times from 2018 to 2021. The leading pathology is diseases of the musculoskeletal system — 28.8–34.2%. The effectiveness of medical rehabilitation of persons with degenerative-dystrophic diseases of the spine and vertebrogenic radiculopathy according to programs based on clinical recommendations (n=52) was compared with a group with a similar pathology (n=50) who underwent rehabilitation before the development of programs. In the main group, relief of symptoms of vertebrogenic radiculopathies was 17.4% more pronounced than in the control group; anxiety – by 14.9 and 32.3%, respectively (p<0.001), local hyperthermia in the area of the affected spinal segment – by 37.6% (p<0.05). Rehabilitation programs formed on the basis of clinical recommendations increase the effectiveness of rehabilitation measures for patients with vertebrogenic radiculopathies at the sanatorium-resort stage of rehabilitation.

The main provisions of the psychophysiological approach to the study of psychogenic disorders of military activity in strategic exercises are considered. The data on personal anxiety in military personnel with and without combat experience was studied before and after the exercise. To effectively solve the problems of the medical service for the prevention of psychogenic disorders, it is recommended to develop a methodology for predicting the psychogenic losses of combatants in the conditions of modern armed conflicts.

The paper presents a clinical case of a 72-year-old patient who, for the first time in a military medical organization, in a hybrid operating room, successfully underwent simultaneous transcatheter aortic valve implantation and endoprosthesis replacement of the abdominal aorta by an endovascular method in a patient with a high surgical risk. In the early postoperative period, acute kidney injury of the 3rd stage developed. Conducted conservative therapy led to regression of signs of renal failure, normalization of serum creatinine (101 mcmol/l) and glomerular filtration rate (64 ml/min/1.73 m2) after 2.5 months. The issues of possible complications and advantages of simultaneous operations on the aorta are discussed. The observation demonstrates the technical feasibility of performing such an operation with a positive clinical result. To assess the risk of possible complications, to conduct a careful selection of patients for simultaneous intervention, a multidisciplinary approach is required with the participation of: a cardiac surgeon, an interventional X-ray surgeon, a doctor of functional diagnostic methods, an anesthesiologist, and a cardiologist.

The use of natural antimicrobial peptides with high antibacterial activity against most microorganisms, including antibiotic-resistant strains and polymicrobial associates (biological films), can be attributed to new methods of managing patients with burns. The experiment included 40 rats weighing 220–240 g, distributed into 4 groups depending on the treatment method: control (without treatment), wet-drying dressings with an antiseptic solution (iodopyron), Levomekol ointment, gel of lightly cross-linked acrylic polymers with natural antimicrobial peptides ... The results were evaluated on the 4th, 7th, 14th, and 28th days. The gel of lightly cross-linked acrylic polymers with natural antimicrobial peptides was most effective: the area of the experimental wound by the 28th day decreased to 0.3±0.1 cm2 (12.6 times less than in the control group), the growth retardation zone of Staphylococcus aureus 209P was 34.9 mm, which is only 3.9 mm less than when using iodopyron, and the frequency of infectious complications and mortality was minimal – 10 and 5%, respectively.

The article provides information about the stages of development of artificial intelligence technologies, presents the classification and current aspects of the use of machine learning methods in various areas of professional activity. These methods are widely used in clinical medicine. In medical-and-preventive medicine, machine learning methods are used very little due to the peculiarities of a number of environmental factors, the interaction of macro- and microorganism, the quality and reliability of numerous processed data. All this significantly increases the complexity of using these methods in predicting infectious morbidity. The preliminary results of our own research on the development of new methods for predicting the level and rise in the incidence of acute respiratory infections in organized teams using one of the machine learning technologies – gradient boosting are presented.

The results of assessments of professional risks of causing harm to health among specialists servicing ground-based radio-technical complexes at state aviation airfields are presented. Personnel may be at risk of overexposure when they work with radio-technical complexes, especially if they enter the beam zone of electromagnetic radiation. The risk of gastrointestinal diseases for the radio engineering complex support group is 1.35 times higher, and for endocrine system diseases, eating disorders and metabolic disorders – 1.4 times higher. The most common among endocrine diseases were obesity, hyperthyroidism, endemic goiter and diabetes mellitus. The endocrine system is critical in the human body and is sensitive to the effects of electromagnetic radiation.

The article discusses the materials for quality control of water for pharmaceutical use (purified water and water for injection), obtained using a sterilization-distillation unit SDP-4. Data on the categorization of water for pharmaceutical use in domestic and foreign practice are given. A comparative assessment of the requirements for water quality showed that there are significant differences in the list of quality indicators, in the norms and methods for their determination. The problem of assessing the quality of water obtained with the help of SDP-4 in the field has been scientifically justified, and two points of control are provided. Microbial contamination has been shown to be the greatest risk to pharmaceutical water quality. In the SDP-4 design, this risk is minimized. The control measures carried out in accordance with their stages, together guarantee the proper level of determination of the quality of the water received. In the process of testing SDP-4 prototypes, it was confirmed that the quality of the obtained purified water met the requirements of the pharmacopoeial article FS.2.2.0020.18 and water for injection – the requirements of FS.2.2.0019.18.

A review of data on the impact of a new coronavirus infection, COVID-19, on cardiovascular diseases is presented. When treating patients, it is necessary to timely apply additional instrumental research methods, control biomarkers of myocardial damage, and reasonably prescribe medications.

The clinical efficacy of non-drug rehabilitation therapy, including psychodiagnostics (testing) and psychotherapeutic conversation with individual recommendations for the correction of “eating behavior” in 257 servicemen under contract with alimentary-constitutional obesity and asthenic syndrome (experimental group) was evaluated. The control group (n=221) with a similar pathology received, like the experimental group, treatment in accordance with clinical recommendations (physiotherapy, medication, diet). In the experimental group, 70.8% of people with alimentary-constitutional obesity I–II degree achieved normal BMI values within 6 months, 58.2% with III degree reduced the index to I–II degree. In the control group, these figures were 32.8 and 27.1%, respectively. A significant decrease in asthenic syndrome was noted in 85.9% of the servicemen of the experimental group and in 39.6% of the control group.

The article presents the history of the formation and approval of scientific concepts of the pathophysiology of traumatic shock, the study of pathogenesis, and the definition of general approaches to its therapy. A significant contribution to the solution of this scientific problem was made by the Academician of the USSR Academy of Medical Sciences, Major General of the Medical Service Kulagin V.K. (1923–1982). His professional biography is closely connected with the Department of Pathophysiology of the Military Medical Academy. S.M.Kirov, where he worked as a teacher since 1955, then as a senior teacher, and in 1967 he was appointed its head. From 1980–1982 he headed the Scientific Research Institute of Military Medicine of the USSR Ministry of Defense. During the leadership of Kulagin V.K. at the Department of Pathophysiology, the main areas of scientific research were the study of the pathogenesis of traumatic shock and the experimental development of the foundations of its prevention and therapy. Today, military medicine continues to be interested in shock as a pathophysiological problem. Its further development can be successful only on a solid scientific foundation laid by the predecessors of today’s scientists, including Kulagin V.K.