Vol 345, No 6 (2024)

Currently, the occurrence of a radiation accident and, as a result, excess exposure of military personnel and the population remains an urgent problem in military medicine and emergency medicine. Amendments to federal legislation defining a special procedure for providing first aid to military personnel, which is regulated not by the Russian Ministry of Health, but by the Russian Ministry of Defense, as well as the increasing role of the so-called. tactical medicine, as part of the provision of first and pre-hospital aid to the wounded and injured, is the basis for revising the activities carried out during the provision of medical care at the pre-hospital stage in the special conditions of the Armed Forces of the Russian Federation. This especially affects the provision of first aid in radioactively contaminated areas, as well as in areas of chemical and biological contamination, because for these conditions in the Russian manuals on tactical medicine, the recommendations are minimal. The article presents a variant of the sequence and content of first and first aid measures in a radioactively contaminated area, which assumes that the border of the source of radioactive contamination is located in the «yellow» tactical zone, and is described using the mnemonic rules (FIST-BARIN)² and (MAP)². Besides the rule (FIST-BARIN)², an algorithm has been developed for performing first aid measures as mutual aid in radioactively contaminated areas.

Treatment of atrial fibrillation remains one of the most important and discussed problems of modern cardiology. Since relapses of arrhythmia and adverse reactions often occur when using antiarrhythmic drugs, catheter technologies have been widely used over the past 30 years. The most widespread among them in clinical practice are radiofrequency ablation and cryoballoon ablation. Modern non-fluoroscopic mapping and navigation systems, irrigated catheters with pressure sensors and cryoballoon ablation make it possible to achieve transmural effects on pathological pathways of the left atrium wall while minimizing the risk of complications. The article outlines the rationale, indications and contraindications for catheter ablation, as well as potential complications.

In order to improve the results of hernioplasty, a method for forming a muscle cuff in the internal inguinal ring for an indirect inguinal hernia has been proposed. Reconstruction of the posterior wall of the inguinal canal begins with the application of a semi-purse-string suture to the transverse fascia along the medial semicircle of the internal inguinal ring. When the suture is tightened, the lower edge of the internal oblique muscle moves down and covers the spermatic cord on the medial side. When the internal oblique muscle is tense, the internal inguinal ring is compressed by its lower edge. The effectiveness and safety of this technique was assessed in 189 (64.5%) male patients with unilateral indirect inguinal hernias (dominant group). The control group consisted of 104 (35.5%) patients operated on according to the classical Lichtenstein method. In the control group, among patients with degree III expansion of the internal inguinal ring, one case (4.7%) of relapse was noted. In terms of intensity and duration of pain in the postoperative period, duration of surgery, and postoperative bed-day, the results in both groups were similar.

The article provides information on the incidence of HIV infection among the population of the Kherson region. In 2020–2021, the sanitary and epidemiological situation in this region regarding this infection was characterized as unstable with an upward trend. The state of the system of providing medical care to HIV-infected people is analyzed. A forecast of the incidence of HIV infection in the Kherson region is presented. Currently, proper measures have been organized and implemented to ensure sanitary and epidemiological well-being of HIV infection and the provision of medical care to the population of the region. The need for HIV testing of all patients admitted to inpatient treatment is emphasized to eliminate the risk of nosocomial HIV infection in medical organizations for both patients and staff. The data presented must be taken into account when planning activities to prevent HIV infection among personnel of military units stationed in a given region.

The purpose of the study is to determine the theoretical and methodological foundations of the process of ensuring the habitability of samples of military equipment of the Ground Forces of the Ministry of Defense of the Russian Federation at the stages of the life cycle. The paper presents an algorithm for integrating the system of actions and the system of methods of medical and technical specialists in the design and examination of the habitability of the created (modernized) model of military equipment. The need for normative legal validity of such integration is shown. A list of concepts relevant to the study is postulated.

The article is devoted to predicting the occurrence and development of unfavorable mental states in pilots during flight. Methodological approaches have been developed that have made it possible, based on an analysis of the relationship between the background and «pre-activity» mental state of a pilot, to formulate a step-by-step algorithm for predicting the likelihood of unfavorable states with psycho-emotional stress occurring in flight. An effective way to predict the occurrence of unfavorable psycho-emotional states in flight among flight personnel is to take into account the results of dynamic psychological observation and assess changes in the level of psycho-emotional stress in the process of professional activity.

A retrospective analysis of the results of 100 bypass operations for arterial reconstruction below the inguinal ligaments was carried out. The patients were divided into two groups depending on the choice of the proximal anastomosis zone: group 1 (50 patients) – proximal anastomosis was performed from the common femoral artery, group 2 (50 observations) – from the deep femoral artery. In the early postoperative period in group 1, wound complications developed in 28% of cases, in group 2 – in 8%. When studying long-term results, no statistically significant differences were revealed in terms of primary shunt patency and amputation-free survival. The choice of the deep femoral artery as a tributary artery when performing infrainguinal autovenous reconstructions significantly facilitates the surgeon’s access to the artery in the presence of technical difficulties in isolating the neurovascular bundle in the vascular lacuna.

The article is dedicated to P.A.Naranovich, a Russian surgeon and anatomist, professor at the St. Petersburg Medical-Surgical Academy, in 1867–1869. – her boss, as well as the editor of the Military Medical Journal. He is one of the founders of anesthesiology in Russia, an enthusiast in the development and use of new instruments and devices in surgery. He combined scientific and teaching activities with practical surgery. P.A.Naranovich was for many years the vice-president of the Society of Russian Doctors in St. Petersburg and was one of the founders of the «Society for the Care of Wounded Warriors» (1867), transformed into the Russian Red Cross Society.

The article is devoted to the biography of Professor Nikolai Alekseevich Bogoraz (1874–1952) – the first chief surgeon of the Main Military Hospital of the Armed Forces of the USSR (now the N.N. Burdenko Main Military Clinical Hospital), the founder of reconstructive surgery, laureate of the USSR State Prize, honored figure sciences of the RSFSR and the Uzbek SSR. The readers are presented with previously unreported pages of the life of this outstanding surgeon, who is an example of high service to the Fatherland and personal courage. Data from scientific medical publications, memories of colleagues and patients are also presented. Documents and photographs from the collections of the General Hospital Museum and the collection of N.A. Bogoraz’s relatives are published for the first time.