Vol 340, No 11 (2019)

The article discusses a military medical examination as a type of medical examination that has significant specificity, which is demonstrated from a professional point of view. The methods of its implementation and competencies necessary for the doctor to carry out this type of medical examination are highlighted. A comparative analysis of the qualification characteristics of medical specialists of military medical commissions was carried out to determine their compliance with the goals and objectives of the military medical examination. The results of the analysis made it possible to justify the feasibility of introducing the professional standard of a specialist in military medical expertise.

A comprehensive radiological survey of 78 victims with a combined injury of the neck and adjacent anatomical areas was performed. Analysis of the results made it possible to objectively assess the possibilities of radiation methods, among which computed tomography has the greatest efficiency. The distribution of radiation signs of combined cervical trauma into syndromes made it possible to single out the leading damage in all cases based on objective data.

The analysis of the results of a questionnaire study of the prevalence of lower urinary tract symptoms, androgen deficiency and erectile dysfunction among 100 young men of the young age of the Western Military District was carried out. Symptoms of the lower urinary tract were detected in 55% of military personnel, mainly in the form of mild dysuric events. A direct dependence of their frequency on the age structure of the respondents has been established. The decline in the quality of life on the background of the symptoms of the lower urinary tract was determined in 41% of cases. Among the major sexological disorders, erectile dysfunction is found in 9% of military personnel, mostly in the form of the mildest form. Clinical manifestations of androgen deficiency in the form of psychological, somatic and sexological symptom complexes were detected in 16% of military personnel.

The article is devoted to the problem of group incidence of tuberculosis in closed military collectives; cases of mass illness and infection of military personnel described in foreign scientific publications and in the works of the department of phthisiology of the Military Medical Academy named after S.M.Kirova. The clinical and epidemiological features of the outbreak of tuberculosis in one of the military units in 2017 are analyzed. The characteristics of the consequences that result from failure to comply with measures to prevent the recruitment of military patients with tuberculosis and the long-term location of the source of mycobacterium tuberculosis in a military team are analyzed. The importance of alertness in relation to tuberculosis infection was shown by the doctors of the draft commissions in the military commissariats and the medical service of military units upon arrival of a young replenishment. The reasons for the occurrence of group morbidity are indicated, suggestions are made for the introduction of modern methods for detecting mycobacterium tuberculosis infection, preventive treatment regimens for people with latent tuberculosis infection, and the order of dispensary monitoring of military personnel at risk of infection.

The work is devoted to the study of the professional health of cadets - first-year pilots of a military school (n=106). The integral level of occupational health in points was calculated based on a set of assessments of clinical status, functional stability and professionally significant psychological and psychophysiological characteristics. It has been established that the greatest «negative contribution» to the overall picture of occupational health is made by indicators of clinical status and functional stability. A significant group of individuals was identified with the compliance of the integral level of occupational health with the «premorbid state» class (46.23%), which is caused by a decrease in the cardiovascular status (17%) and functional stability (38%).

A clinical example shows the possibilities of diagnosis and surgical treatment of a Dieulafoy’s lesion in combination with a pancreatic tumor when it is impossible to perform adequate endoscopic hemostasis or embolization. The manifestation of a Dieulafoy’s lesion is possibly caused by changes in vascular architectonics due to a pancreatic tumor. Clinical observation demonstrates a rare combination of neoplasm and vascular malformation, difficulty in diagnosing endoscopic examination, computed tomography and angiography, as well as options for surgical tactics for this pathology.

In 2019, the 150th anniversary of the birth of Sergei Petrovich Fedorov (1869-1936), one of the leading surgeons in the first third of the 20th century, who is the pride of Russian surgery, was celebrated. During the 45-year medical and scientific-pedagogical activity, he created the surgical and urological scientific schools, known not only in Russia but also in Europe, which played a large role in the development of Russian medicine. As a tribute to the great surgeon of Russia, the Inter-Regional Scientific and Practical Conference «Innovative Technologies in Surgery and Urology» was held at the Military Medical Academy.

The article describes the facts related to the publication in 1944 of a publication based on the lecture to students of the medical institute by professor S.S.Yudin at the opening of the department of the hospital and surgical clinic. A vivid, emotional and erudite presentation on the history of military field surgery was to serve the patriotic and moral goals of educating future military doctors who went to the front. S.S.Yudin supplemented his excursion into the history of Russian medicine with his own memories of his participation in the First World War, personal impressions of meeting N.A.Veliaminov and communication with N.N.Burdenko, a story about the invention of a plaster cast, which he improved and B.A.Petrov and was widely used during the Great Patriotic War of 1941-1945.

A report is presented on the world conference held in early June 2019 in St. Petersburg on the use of x-ray surgical methods in injury surgery and emergency surgery. The conference was organized by the Military Medical Academy named after S.M.Kirov, the St. Petersburg Scientific Research Institute of Emergency Medicine named after I.I.Dzhanelidze, the Scientific Research Institute of Emergency Medicine named after N.V.Sklifosovsky and the St. Petersburg State Pediatric Academy. The conference was attended by more than 350 surgeons, traumatologists, anesthetists, obstetrician-gynecologists, vascular and endovascular surgeons, emergency doctors from more than 15 countries. The scientific program considered during the forum was at the junction of many medical specialties, attracting not only civilian, but also military doctors from around the world.