Vol 339, No 4 (2018)

The incidence of military servicemen under contract in the rank of rank-and-file sergeant for 10 years (2007-2016) was studied by analyzing 60% of the annual reports on the health status of personnel and medical service activities in the form 3/MED military of randomly selected units. The average annual incidence rate was 982±33‰, the primary level was 483±13, the need for dispensary observation was 72±5, the total hospitalization was 239±8, the days of work loss were 3913±115, the dismissal for health reasons was 4.1±0.5‰, mortality - 102.7±8.1 per 100 thousand military personnel under the contract. An increase in the rates of general and primary morbidity and a decrease in the rest have been established. Compared to officers, the contracted servicemen had significantly lower levels of overall morbidity, need for dispensary dynamic follow-up, labor losses and layoffs, higher hospitalizations, almost identical - primary morbidity and mortality. The pathology XIX (trauma, poisoning and some other consequences of external causes), X (diseases of the respiratory system), IX (diseases of the circulatory system), XIII (diseases of the musculoskeletal system and connective tissue), XI (diseases of the digestive system), XII (diseases of the skin and subcutaneous tissue) and V (mental and behavioral disorders) classes. Prevention of diseases and injuries of these classes will help preserve and strengthen the health of contract servicemen - privates and sergeants.

The article is devoted to infectious complications of the sternotoma wound in cardiosurgical patients. The study included 52 patients with infectious complications of the sternotoma wound after open cardiac surgery. The risk factors for the development of postoperative mediastinitis are severe heart failure of NYHA class III-IV (in 52% of patients), chronic obstructive pulmonary disease (40.4%), diabetes mellitus (32.7%), duration of surgery and artificial circulation, formed instability of the sternum (in 45.8%). The main causative agents of the infectious process were coagulase-negative and golden staphylococci (including methicillin-resistant strains). The treatment of superficial and deep (with mediastinitis) sternal wounds varied from prolonged antibiotic therapy with surgical treatment of the wound to resections of the destructive sites of the sternum, costal arches with gradual application of vacuum assisted bandages and plastic reconstructive interventions. In a prospective group of 12 patients with postoperative mediastinitis of types III-V, there was a decrease in the relapse rate from 27.3 to 16.7% compared with the retrospective treatment indices of patients without using the method of vacuum-drainage of wounds.

The article presents the characteristics of modern organic equipment supplied according to the state defence order for equipment of military units and military medical institutions of the Armed Forces of the Russian Federation in mobile medical complexes on the basis of pneumo-framed constructions. Revealed the procedure for operational tests of medical equipment kits, medical kits and presented its results. Promising ways of improvement of the organic equipment and medical complexes on the basis of pneumo-framed constructions are given.

Gunshot wounds of the spine account for 10-21% of all spinal and cerebro-spinal injuries of civil and military time. Most gunshot penetrating wounds do not impair the stability of the spine, and in some cases are not accompanied by damage to the bone structure and do not require stabilizing aids. The article discusses the possibility and discusses the expediency of using minimally invasive surgical methods for gunshot wounds of the spine, in particular percutaneous video endoscopy, on the example of its successful implementation in a 24-year-old man who received a gunshot blind penetrating wound in the lumbar spine.

The experience of the use of inhibitors of ranibizumab angiogenesis and aflibercept in the treatment of 81 patients with exudative form of age-related macular degeneration is presented. Both drugs have proved to be convenient, high-quality and safe means. In some patients, after cessation of therapy with angiogenesis inhibitors, choroidal neovascularization recurs and disease progresses. Therefore, patients receiving treatment are strongly encouraged to conduct regular medical examinations and regular check-ups from an ophthalmologist.

The results of the complex medical rehabilitation in combination with alpha-training using biofeedback for studying the degree of treatment effectiveness of 60 children of primary school age with attention deficient hyperactivity disorder are presented. Restorative treatment was conducted with the use of alpha training in conjunction with standard spa factors.

The article presents extensive material on the history of the formation and development of military medical examination in Russia. The role of domestic scientists in the scientific and practical substantiation of the need and tasks of medical examination of draftees and military servicemen in the army, the definition of eligibility criteria for military service, and the preservation of the health of servicemen are discussed in detail. The role of the organizers in the formation and development of the medical-flight examination bodies was noted. Particular attention is paid to the role of military medical examination in the years of the Great Patriotic War (1941-1945), the specifics of the work on the selection and examination of the conscription and military personnel, the monitoring of medical and diagnostic activities of military hospitals, the correctness of the establishment of fitness for military service after wounds. Contains extensive material on the organization of military medical examination in the postwar years, the improvement of its forms and methodological foundations at the present stage of the development of the Armed Forces.

The article deals with the activity of the Kirov Institute of Epidemiology and Microbiology during the Great Patriotic War. The Institute was engaged in the production of bacteriological preparations for medical and preventive purposes for the front and rear on a nationwide scale, and also conducted research, organizational, methodological and practical work, actively cooperated with local health authorities and made a significant contribution to the restoration and preservation of the health of the wounded and sick soldiers of the Red Army, the Navy, the peaceful population of the Kirov region and the entire Soviet Union. The activity of the Institute in the scientific literature is practically not covered.