Vol 344, No 4 (2023)

Changes in the system of providing surgical care to the wounded at the initial stage of a special military operation are analyzed, taking into account the nature of hostilities. The features of combat surgical pathology and the nature of pre-hospital and surgical care for the wounded are shown. Attention is focused on maintaining qualified surgical care, which is of paramount importance for saving the lives of the wounded by reducing the time for urgent surgical interventions. Approaching the wounded with specialized surgical care is implemented by deploying special-purpose medical teams in evacuation areas and using local civilian medical organizations with attached medical reinforcement groups. For the first time in the stages of medical evacuation, the surgical tactics of «damage control» are widely used. It is shown that the training of a wide range of doctors and paramedical workers in military field surgery is insufficient, which requires urgent organizational measures at the federal level.

An analysis of our own experience in providing specialized vascular care in a basic medical institutionto 13 victims delivered from the stage of qualified medical care after temporary intravascular shuntingis presented. Defects made at the previous stages of medical evacuation were identified and analyzed.The effectiveness of this method of preserving the viability of the limb has been confirmed. Indications for the use of intravascular shunting should be individual and correspond, first of all, to the severity of limb ischemia. Additional training is needed for surgeons and traumatologists assisting at the advanced stagesof medical evacuation on issues of injury to the main vessels.

The purpose of the study was to conduct a comparative assessment of the effectiveness of the use of autoplasma with an increased content of platelets, got by the P-PRP and L-PRP methods, in the treatment of chronic corneal erosions. The work was performed on 18 chinchilla rabbits (36 eyes) in 2 stages. On the first animal, a model of experimental chronic erosion of the cornea by ultraviolet radiation was reproduced. At the second stage, the animals were divided into 3 groups (6 individuals in each). In the 1st group, P-PRP therapy was carried out according to our scheme: instillationof P-PRP 1 drop every 1 minute for 10 minutes (10 drops) once a day for 5 days. According to a similar scheme, in the 2nd – L-PRP therapy. In the 3rd (control) – standard conservative therapy. Using autoplasma with an increased content of platelets, got by the P-PRP and L-PRP methods, accelerates the epithelization of chronic corneal erosions compared to standard conservative treatment. According to morphological studies, the use of P-PRP is a more effective method of treatment compared to L-PRP.

A description of the etiopathogenesis, clinical manifestations, diagnosis, and treatment of spinal nerve schwannomas are presented. Clinical observations of schwannomas in servicemen, confirmed by histological data, are presented. The considered pathology occupies a significant place among intradural-extramedullary tumors of the spinal cord. To clarify the localization, size, and prevalence of the tumor, the method of choice is magnetic resonance imaging. Computed tomography with reconstruction makes it possible to determine the nature of destruction and the extent of damage to bone structures. Most cases of the newly diagnosed disease occur in patients of working age. Schwannomas are solitary tumors, in the case of multiple lesions, neurofibromatosis should be excluded.

The purpose of the study is to identify problematic issues and identify ways to improve the regulatory support for the habitability of weapons, military and special equipment at the stages of the life cycle.The paper for the first time applied a new conceptual approach to the habitability of military equipment samples as an independent object of military medical standardization, including planning by forminga package of reasonable physiological and hygienic requirements for the environmental factors ofthe sample, their observance with the help of adequate technical means of ensuring habitability, control using a reliable expert system. The directions for improving the normative provision of habitability are substantiated: the study of the complex impact of environmental factors on a human operator, the development of methods for the physiological and hygienic regulation of the habitability of samples, the rules forthe interaction of medical and technical specialists in designing habitability and methods for its examination.

The purpose of the study is to assess the state of the functions of the human body when breathing oxygen and a 40% oxygen-nitrogen mixture under high pressure. 40 men aged 23–43 years were examined. The dynamics of the state of functions of the respiratory, cardiovascular, and central nervous systems were assessed during breathing with hyperoxic mixtures under high pressure. Breathing oxygen in a pressure chamber (рО2=250 kPa) is accompanied by a decrease in the efficiency and level of adaptive reserves of the cardiovascular system and an improvement in the cognitive functions of the brain. Breathing a 40% oxygen-nitrogen mixture at a pressure of 0.3 MPa (рО2= 120 kPa) does not adversely affect the state of body functions, and therefore it is preferable to use it when carrying out diving operations at depths up to 20 m. To assess the performance and level adaptation reserves of the cardiovascular system during the examination and selection of divers working with hyperoxic mixtures, it is recommended to use a test with increasing dosed physical activity.

The results of the analysis of the work of the infectious center for the period from 05/01/2020 to 04/30/2022 are presented. Retrospectively (05/01/2020–05/01/2021), 575 cases of hospitalization of patients with COVID-19 were studied. Most patients (80.5%) were hospitalized after 4 days of outpatient treatment. Patients aged 51–70 years (73.5%) prevailed – military pensioners and their family members with 2 or more concomitant diseases (90%), with a moderate course of the disease (81%). Mortality rate over 2 years of follow-up was 3.4%.

The article is devoted to the use of instrumental methods in the diagnosis of primary obesity in military personnel undergoing military service under the contract. In the course of scientific and practical work, 103 servicemen with obesity of 1–3 degrees were examined. The results obtained show a low degree of the information content of the body mass index, which does not take into account the individual constitutional characteristics of a person. A comprehensive approach to the examination of overweight patients is proposed, which helps to assess the ratio of muscle and adipose tissue in the body and avoids overdiagnosis of obesity.

The article provides an example of early diagnosis of pancreatic cancer with isolated dilatation of the veins of the stomach. Using ultrasound, CT and MRI methods of the abdominal organs revealed hepatomegaly and diffuse heterogeneity of the pancreatic parenchyma in the patient. Laparoscopic distal resection of the pancreas with splenectomy was performed. Histological examination verified low-grade ductal adenocarcinoma. Conducted a course of chemotherapy. Thus, an adequate interpretation of the results of routine instrumental studies makes it possible to verify oncopathology at an early stage, which improves the prognosis, duration and quality of life of the patient.

The article is devoted to the history and present-day of the 1409th Naval Clinical Hospital, formed in November 1942 in the city of Serpukhov (Moscow Region) based on two city hospitals. In the post-war period, the hospital participated in the provision of medical care in the event of an accident at the Chornobyl nuclear power plant, in hot spots (Afghanistan, the Chechen Republic, Syria, etc.). The basis of the hospital’s work is the constant introduction of new methods of diagnosis and treatment, and the development of high-tech medical care. In the context of the COVID-19 pandemic, the hospital has successfully managed to provide comprehensive medical care to patients with coronavirus infection. Throughout history, the hospital has been distinguished by the high professionalism of its employees and their devotion to the best traditions of military and domestic medicine.

The article is devoted to the 225th anniversary of the Russian military doctor A.A.Charukovsky, doctor of medicine and surgery, author of the fundamental work «Military field medicine» (1836–1837), in which he summarized the experience of medical support for the Russian army in the early 19th century, both in peacetime and in wartime. He is also the author of the fundamental work on hygiene and medical geography «Folk Medicine Applied to Russian Life and the Different Climates of Russia» (1840–1845). A.A.Charukovsky actively collaborated in the «Military Medical Journal» and the newspaper «Friendof Health», publishing articles on clinical and hygienic topics in them.

Based on the Military Medical Academy on November 23–24, 2022, the All-Russian Scientific and Practical Conference «Topical Issues of Maxillofacial Surgery and Dentistry» was held, dedicated to the 100th anniversary of the birth of Professor V.A.Malyshev. The conference was attended by heads (heads) of departments (centers) of maxillofacial surgery and dentistry and dental departments of centrally subordinated hospitals, military (military-clinical) hospitals, and their branches (with a bed capacity of 300 beds), including treatment and diagnostic centers and consultative and diagnostic polyclinics, representatives of the country’s dental community from Kaliningrad to Vladivostok. In total, over 400 people took partin the event, including heads of departments, faculty, and students of the Academy and other universities of the country. The reports of the participants were devoted to scientific achievements and scientific and practical research on topical issues of maxillofacial surgery, and improvement of methods for diagnosing, treating, and preventing dental diseases. Particular attention is paid to the treatment of injuries ofthe maxillofacial region.