卷 345, 编号 9 (2024)

The study is devoted to the substantiation and development of methodological and methodological foundations of hygienic diagnostics based on the study of its subject area, goal setting, structure, stages, methodological base, subject and object of research. Systematization and analysis of the research results of domestic and foreign hygienic scientific schools on the problem «Methodological and methodological foundations of primary preventive activities» were carried out. The historical experience of the diagnostic process in hygiene is assessed. Original approaches to assessing the structure, targets, and subject area of hygienic diagnostics have been substantiated and developed. A definition of the term «hygienic diagnostics» has been formulated, reflecting the specifics of this stage of medical prevention. A comparative analysis of the specifics of clinical and hygienic diagnostics was carried out. Schemes of hygienic diagnostics are presented as an algorithm (cybernetic approach) and a system (system approach). The sequence of stages of primary preventive activity as a cyclic spiral is shown, the role of hygienic diagnostics in the system of medical prevention is shown.

The goal is, based on an analysis of literature data on research aimed at modeling combat stress, to identify the main directions for creating new animal models suitable for behavioral research, and the features of organizing research on volunteers. A decomposition of the concept of «combat stress» was carried out, highlighting the physiological and psychological components. The need for an integrated approach is shown, including, besides psychological methods, a complex of neurophysiological, biochemical and morphological studies, which requires the creation of relevant animal models. There are 4 groups of stress factors: external, physiological, emotional. In a comparative manner, 6 animal models of combat stress were assessed. Domestic models reproduce not combat stress itself, but its negative consequences – post-traumatic stress disorder. This limits the use of combat stress models in animals, since it does not allow studying the state of constructive combat stress (eustress), behavioral reactions, physiological, biochemical and structural changes during its development. However, it is adaptation to combat stress that distinguishes veterans from recruits and is the task to which the major effort in combatant training is directed. The authors identified the basic requirements for a model of combat stress in animals, as well as principles, the observance of which during clinical studies will allow us to qualitatively model the functional state of combat stress and increase the safety of volunteer participation in the study.

A comprehensive psychophysiological examination was carried out on 43 men in 2 age groups – up to 40 years (n=29), 40 years and older (n=14), who were injured (lower limb amputation) in the zone of a special military operation. Immediately before osteopathic treatment, immediately after it and 1.5–2 months after the start of treatment, the effectiveness of complex medical rehabilitation of combatants using osteopathic treatment was assessed. It was established that the initial functional state of the combatants’ body was at a low level. Indicators of the functional state of the central nervous system, subjective state, vegetative status and quality of life of patients under the age of 40 years are significantly higher than in the age group of 40 years and older. Already, after the first session of osteopathic treatment, the majority of patients improved their functional state indices in both age groups.

The article provides information about the sanitary and epidemiological situation regarding HIV infection in the Armed Forces of the Russian Federation. A pronounced connection was noted between the increase in the registration of HIV infection among military personnel with the start of a special military operation and the implementation of measures to replenish military units with personnel. It is concluded that the existing procedure for expert laboratory diagnosis of HIV infection, as well as the forms and procedure for interaction in cases of HIV infection in military medical organizations do not meet the needs of the Russian Ministry of Defense during the Northern Military District and need to be revised. Proposals have been formulated to optimize the system of diagnostics, information interaction, and prevention of HIV infection in the Armed Forces of the Russian Federation

The article analyzes the possibilities of digitalization of diagnostic and correctional work with military personnel on combat duty in order to increase their professional reliability. The article identifies four stages of digitalization: data collection and primary processing. For each stage, the most promising and effective areas of digitalization and the existing technological groundwork that ensures its possibility are considered.

The goal is to assess the organization and provision of medical care to flight personnel after an emergency indication of the aircraft. We analyzed 333 injuries received by 214 crew members during ejection from an aircraft in 1980–2020. Including 106 people (49.5%) received severe injuries, 100 (46.7%) received minor injuries, and another 5 (2.8%) received moderate injuries. A minimum of 34.6% of pilots required first aid. First aid as self- and mutual aid was provided to only 7.7% of injured crew members; 37.5% of ejected crew members received first aid from search and rescue groups, which included medical workers. A fairly rapid evacuation from the accident site was noted: half of the crews were delivered to the airfield less than 2 hours after the ejection. To increase the efficiency of first aid, it is advisable to equip the flight crew with modern effective non-narcotic painkillers and hemostatic agents, including tourniquets or tourniquets, by additionally equipping a portable emergency supply of the medical group or by providing compact portable first aid kits with the minimum necessary medical equipment.

The authors present a brief history of the functioning and current state of Branch No. 2 of the Federal State Budgetary Institution «National Medical Research Center for VMT named after A.A.Vishnevsky» of the Russian Ministry of Defense. The leading direction of the Branch’s activities in modern conditions is the provision of comprehensive rehabilitation of military personnel with combat trauma within the framework of medical, psychological, social and professional rehabilitation. Currently, thanks to its organizational structure, accumulated experience, high professional level of specialists, the presence of a developed material and technical base and modern high-tech and innovative equipment, the Branch is rightfully one of the largest and leading clinics in the Russian Federation, providing comprehensive rehabilitation care and successfully solving the most complex and comprehensive tasks of preserving the health of military personnel.

The article presents proceedings of the All-Russian interdepartmental scientific and practical conference «Acute radiation injuries: prevention, detection, and treatment, contemporary challenges and solutions» hosted in Saint Petersburg on April 2, 2024, by the State scientific research test Institute of military medicine of the Russian Defense Ministry and the Russian Academy of Sciences’ radiobiological community. The conference considered major aspects of healthcare delivery in radiation injuries, as well as the progress on contemporary experimental radiobiology: research methodologies in radiobiology, bioindication and radiation injuries dosimetry, diagnostic consideration of the existing and perspective acute radiation injury’s detection criteria and prognosis determination, acute radiation injuries clinical classification as a basis for the clinical guideline development, preventive and early therapeutic interventions in acute radiation injuries, radiation injuries’ modeling; medical and preventative measures’ organization and implementation while working under excess irradiation. The result of the conference was decision for on the need to improve the regulatory and methodological framework for the procedure of healthcare delivery in radiation injuries in medical organizations of various departmental affiliations.