Vol 345, No 4 (2024)

The results of the analysis of the application of the electron microscopy method at the S.M.Kirov Military Medical Academy in 2019–2023 The possibilities and limitations of the method are shown, the relevance of morphological studies at ultra-high magnifications in such areas as nephrology, dentistry, virology, maxillofacial surgery, as well as in the study of the properties of materials, including their ability to act as carriers for cell cultures, cytotoxic properties. Scanning electron microscopy has played an important role in the study of the new coronavirus infection. Electron microscopy made it possible to study the properties of filling materials and their effect on dental tissues, and to begin studying the morphological characteristics of changes in body tissues in maxillofacial disorders. Electronic photographs obtained during the transmission mode of operation of the microscope were used to establish and confirm the diagnosis of patients with nephropathies, disorders of the ultrastructure of muscle tissue and tendons.

The first in Russia description of a clinical observation of a new coronavirus infection (COVID-19), which was complicated by the development of severe lung damage, rapidly progressive glomerulonephritis with the formation of antibodies to the glomerular basement membrane, polyserositis (hydrothorax, hydropericardium, ascites), dilatation of the heart cavities, hepatolienal syndrome, anemia of mixed genesis (nephrogenic, iron deficiency) of moderate severity is given. The pathophysiological features of multiple organ pathology in a patient with COVID-19 and kidney disease are discussed. The role of the systemic inflammatory response syndrome resulting from the cytokine storm is emphasized. The issues of complex examination, differential diagnostics and specialized treatment are reflected. Taking into account the multisystem nature of the lesion and the development of post-COVID complications, patients should be under the dispensary and dynamic registration of a multidisciplinary team of doctors (therapist, nephrologist, pulmonologist, cardiologist, gastroenterologist, hematologist) for a long time (at least 9 months) with comprehensive monitoring of the function of the kidneys, lungs, heart, other organs and systems, with renal replacement therapy, which improves the prognosis of the life of such patients.

After being postponed to 2020–2022. coronavirus infection for 6 months – 1 year, patients (n=162, age 45–85 years) experienced post-Covid syndrome as increased fatigue, dizziness, general weakness, impaired attention, memory, memorization, shortness of breath, feeling of lack of air and full breath, sweating, palpitations, pain in the joints, spine, numbness of the limbs. The doctors diagnosed all of them with exacerbation of existing chronic diseases. The choice of non-drug restorative treatment is associated with the use of numerous drugs and their side effects in the treatment of coronavirus infection. The treatment program included the combined use of intravenous laser hemocorrection and intravenous ozone therapy. In 144 patients (88%), symptoms disappeared or their severity decreased significantly. In 14 (8.5%) cases, no improvement or deterioration of the condition was noted. 4 patients did not complete the course because of family reasons. Such results were obtained only with the combined use of these methods.

Nausea and vomiting are common and serious complications in the treatment of malignant neoplasms. The introduction of more effective antiemetic agents into oncological practice has made it possible to prevent the development of these adverse events completely in the vast majority of patients. Thus, modern anti-emetogenic therapy regimens make it possible to achieve a complete absence of vomiting in 70–90% of patients. Many studies have shown that antiemetic regimens are more effective in preventing vomiting, so even after achieving a complete response to antiemetic therapy, many cancer patients still experience a burdensome feeling of nausea. Thus, despite the success of modern methods, achieving absolute control not only over vomiting but also over nausea remains an unsolved problem in oncology.

The results of an assessment of the epidemiological situation regarding tuberculosis in Russia and in the states of the world most affected by the new coronavirus infection (COVID-19) are presented. The effect of a number of factors that led to an increase in mortality rates from tuberculosis against the backdrop of the COVID-19 pandemic is shown. The main problems of organizing the prevention and control of tuberculosis during a pandemic are outlined, related both to the complexity of the work of medical organizations (multiple increase in the number of patients, reduced availability of TB care, reduction in healthcare resources, etc.), and the influence of the “human factor” (for example, refusal to be tested for tuberculosis due to fear of infection with COVID-19). It was established that untimely and defective diagnosis of tuberculosis led to an imaginary decrease in the incidence rate. It was concluded that the complex effect of the above epidemic risk factors after the end of the COVID-19 pandemic can lead to a complication of the epidemiological situation and an increase in morbidity and mortality from tuberculosis infection.

The vestibular stability of flight personnel is one of the mandatory elements of assessment during examination by an otorhinolaryngologist as part of the annual medical flight examination, as well as upon admission to universities for the training of flight personnel. Assessment of vestibular stability is traditionally carried out using methods of continuous and intermittent accumulation of Coriolis accelerations. An isolated assessment of vestibular stability is not ideal due to the wide boundaries within each of the possible degrees of stability. An alternative method is the method of computer stabilography, which has high accuracy and ease of use, eliminating the appearance of vegetative and somatic reactions in the subjects during the examination. The conducted survey of 51 pilots operating various types of aircraft allowed us to obtain new data on the relationship of statokinetic stability with the type of aircraft. Thus, pilots flying fighter jets have better indicators of statokinetic stability compared to pilots operating transport aircraft. The pilots were also examined to study the type of nervous system: the data obtained indicate the predominance among pilots operating fighters of a larger number of persons with a strong and medium type of nervous system.

The quality of finished medicinal products depends, among other things, on compliance with the requirements for each stage of their life cycle. One of the longest stages is storage, and therefore particularly stringent requirements are imposed on it. To achieve compliance with storage conditions for medicines, we introduce technical means, create and monitor the necessary climatic conditions, provide storage equipment, security systems, and establish protocols for preventing and responding to emergency situations. The article describes the experience of the pharmacy of the 12th consultative and diagnostic center of the Ministry of Defense in the operation of installed equipment in premises after major repairs in order to comply with the requirements of the general pharmacopoeial article «Storage of Medicines».

The problems of providing vascular care at the stages of medical evacuation in a special military operation are analyzed, the possibilities are assessed and directions for improving the provision of specialized medical care to the wounded with injuries to the main arteries of the extremities, accompanied by the death of muscle tissue due to acute ischemia, are outlined.

An analysis was carried out and the immediate and long-term results of treatment of patients with varicose veins of the lower extremities in a clinic were assessed. It was established that the use of modern minimally invasive treatment methods, including the use of domestic lasers and light guides, tumescent anesthesia, performed under echo control, significantly reduced the degree of damage to surrounding soft tissues, avoided complications, provided good results of outpatient treatment and reduced the time temporary disability of patients.

The authors carried out a retrospective analysis of the contribution of military doctors to national culture and art. In this context, the classic works of military doctors from different historical eras have been studied. It was established that many of the medical service officers successfully combined medical and creative activities. This allowed them to use such effective means as literature, music, and painting widely in order to treat not only the body but also the soul. The need to popularize the military work of military medical specialists and their creative heritage in society is substantiated.

The results of the last All-Russian scientific and practical conference, «Theoretical and practical issues of clinical dentistry» are analyzed. The purpose of the conference was to form a scientific and practical cluster based on the department and clinic of general dentistry, uniting various areas in the specialty «dentistry», creating conditions for personal communication, exchange of experience, establishing professional connections, as well as strengthening interdisciplinary interaction and development of domestic dentistry, introducing new elements of the educational process. The conference format involved parallel work on several platforms, each of which was in demand and useful for the participants. The conference was attended by specialists from Moscow, St. Petersburg, Voronezh, Samara, Smolensk, Chita, and other Russian cities: more than 300 participants. The participants attended a round table where they discussed the most significant aspects of outpatient dental care. The format of a collection of scientific articles presents the results of the conference.