Vol 338, No 10 (2017)

The article presents the results of commission forensic medical examinations and studies conducted in 2016-2017. On instructions from military law enforcement agencies with a view to establishing the justification for making judgments to citizens during the draft campaigns on the category of fitness for military service for health reasons. As a result, it was possible to confirm the conclusion on the category of fitness for military service in only 45,5%. 53% of conscripts did not have the opportunity to express an opinion on the suitability category, either it was not possible or an expert opinion was issued on its change - from limited to military service at suitable for military service with insignificant restrictions. In 1,5% of cases, the experts «weighted» the issued opinion on the category of validity - from limited to the military service at not suitable for military service. The main reasons why the experts did not confirm the conclusions on the category of fitness for military service issued to recruits in military commissariats were established. The ways of eliminating the shortcomings in the work of conscription commissions of municipalities, military commissariats and medical organizations of the public health system are suggested.

The clinical experience of complex treatment of victims with the syndrome of prolonged compression during extraction and in the airborne hospital of the Ministry of Emergency Situations of Russia with the use of domestic nanotechnologies - an unparalleled membrane plasmapheresis during the liquidation of medical consequences of earthquakes (Indonesia, Pakistan, 2005; China, 2008; Haiti, 2010). The prevention of ischemic toxicosis it is necessary to conduct directly when extracting the injured from the obstruction by physicians anesthesiologists-resuscitators and surgeons from the search and rescue units. Consistently continue it at all stages of medical evacuation, during an air medical evacuation to the moment of admission to a specialized hospital. The method of detoxification and the volume of medical care provided when extracting the victim significantly influenced the results of treatment outcomes in the airborne hospital of the victims. The use in the first hours of an unparalleled membrane plasmapheresis in the complex therapy of crush syndrome allows reducing the development of severe forms of endotoxicosis, to provide quality training for the victims to medical evacuation, to prevent the development of acute renal failure, and to improve the prognosis of survivorship.

In the structure of injuries among military personnel admitted to medical institutions, injuries to the musculoskeletal system are 46,7%, ankle injury - up to 20% of cases from their number. In 60% of patients, after ankle fracture, ankle arthritis disease develops, which in most cases leads to disability or a change in the category of fitness for military service. The optimal method, which allows minimally invasive and high-efficiency treatment of patients with ankle arthritis of I-II stage, in whose anamnesis there is a fracture of the ankles, is the treatment and diagnostic arthroscopy of the ankle joint. This method allows the majority of military personnel to return to service without changing the category of fitness for military service and improve the quality of life, which is confirmed by the AOFAS (Kitaoka H.): the rate of excellent results are 47,1% higher, and unsatisfactory results are 23,5% less compared with those who received only conservative treatment.

This article describes the possibilities of radiofrequency ablation of superficial and perforator veins for patients with chronic venous insufficiency and management of the venous ulcers with air-plasma currents of nitric monooxide. Were performed 113 operations of radiofrequency ablation of incompetent superficial and perforating veins, including 22 operations of radiofrequency ablation of incompetent perforating veins. Were compared SEPS operations and operations of radiofrequency ablation of perforating veins in patients with post phlebothrombosis ulcers (C6 СЕАР). The effects of air-plasma currents of nitric monoxide in the venous ulcers treatment in 29 patients were studied. The relevance and effectiveness of the operations of radiofrequency ablation and the nitric monoxide ulcers treatment were shown.

Authors work in the epidemic period, the incidence of respiratory diseases, including acute respiratory infections in 2014-2015, and during the formation of new military groups. The work was carried out using the method of simple comparative controlled epidemiological experiment in two stages: 1st - study the effectiveness of various means of preventing non-specific (drugs «Kagocel» and «Human Immunoglobulin normal»); 2nd - the study of the effectiveness of the combined use of various means of preventing non-specific (against application of the preparation «Normal Human Immunoglobulin», other drugs were used: «Kagocel» and «Ingavirin»). The purpose of practical work was to study the effectiveness of the means of non-specific prevention of influenza and other acute respiratory infections, either alone or in combination with each other. The study found that a single application of funds used in the experiment of non-specific prevention of influenza and other acute respiratory infections effectively, while their combined use is not advisable, due to the lack of expected additive effect.

Presented by the clinical observation of a young patient with an acute myocardial infarction at the age of 18 years. In a retrospective evaluation of the likelihood of the risk of cardiovascular disease by currently known scales in patients defined low risk. At the same time disease is characterized by severe recurrent course against the background of complex therapy. The authors covered issues of diagnostics, conservative and surgical treatment of acute myocardial infarction.

Based on the examination of 121 patients with mitral valve prolapse, the analysis of heart rhythm disturbances was performed depending on the severity of the structural changes in the valves of the valvular apparatus. Performed transthoracic and transesophageal echocardiography, 24-hour Holter ECG monitoring. In patients with myxomatous degeneration of the mitral valve flaps, the frequency of recorded rhythm disturbances (including ventricular arrhythmias) markedly prevailed compared with patients with non-classical mitral valve prolapse.

The US monopoly possession of nuclear weapons and the results of its use against Japan at the end of the Second World War gave rise to the desire of politicians of the Western world to use it against the USSR. It became clear that in the conditions of the «cold war» this, eventually, could happen. The USSR leadership took measures to create a reliable nuclear shield and establish the 12th Main Directorate of the Ministry of Defense of the Russian Federation. From the day of foundation of the 12th Main Directorate, one of the main directions of its activities are measures to maintain high professional efficiency and preserve the health of personnel, as well as to protect personnel from the damaging factors of ionizing radiation.

Тhe article presents the main results of the research of special tactical exercises conducted to assess the effectiveness of medical and medico-psychological support of personnel taking part in liquidation of consequences of nuclear materials. We consider the completeness and quality of working out the planning and implementation of health care questions the use of the personnel and advanced medical devices radiation protection of personnel involved in the accident and called to its liquidation. The necessity of improving the organization of the supply of emergency rescue teams specialized medical supplies, upgrade the clinical database to provide specialized, including high-tech, medical aid to the victims with acute radiation damage, recreating on clinical aspects of health care delivery system for training specialists in acute radiation injury.