Vol 342, No 7 (2021)

The features of the provision of primary health care in the multidisciplinary diagnostic and treatment center of the Ministry of Defense in the context of a pandemic of a new coronavirus infection are outlined. The treatment and diagnostic process were based on the developed algorithm for the work of doctors of treatment and diagnostic units, patient routing. The algorithm is based on the principles and methodological approaches to the diagnosis and treatment of a new coronavirus infection of the Ministry of Health of Russia. The accumulated experience of medical rehabilitation of patients who have undergone COVID-19 and vaccine prophylaxis is analyzed. The performance indicators of a medical organization were evaluated, confirming its sufficient efficiency and high clinical effectiveness.

The analysis of studies devoted to methods of prevention of thromboembolic complications in patients with various forms of atrial fibrillation is presented. The main focus was on pharmacological methods for the prevention of ischemic stroke and systemic thromboembolism. The basic principles of choosing the optimal anticoagulant therapy, taking into account the risk factors for thromboembolic complications and bleeding, as well as patients’ polymorbidity, are outlined. The main indications for the use of oral anticoagulants are described. An algorithm for choosing the optimal anticoagulant therapy in patients with atrial fibrillation after percutaneous coronary intervention with the acute coronary syndrome and stable coronary artery disease, as well as with catheter ablation, has been demonstrated. Non - pharmacological methods for the prevention of thromboembolic complications are highlighted with a description of the main indications for implantation of occluders in the left atrial appendage, its surgical occlusion, or isolation.

The aim of the study was to determine the influence of the anatomical features of the development of the visceral aortic arteries on the formation of endolics after arthroplasty of the abdominal aortic aneurysm. 54 endoprosthetics were performed. Endolic type II was diagnosed in 4 cases, including 3 cases of its spontaneous closure after 1-6 months. In one patient, the inferior mesenteric artery with a diameter of 2.8 mm was the source of endolysis. Endovascular treatment of an abdominal aortic aneurysm remains the prerogative of large vascular centers with extensive experience in surgical interventions on the aorta and the possibility of long - term patient follow - up. The postoperative examination protocol is aimed at identifying arterial blood flow between the endoprosthesis and the walls of the aneurysm (endolic), determining the dynamics of the size of the residual aneurysmal sac, as well as such mechanical changes in the device as migration, bending, and breakage of the stent - graft. The tactics of treatment for endolysis due to retrograde blood flow from the branches of the abdominal aorta (type II) is not fully defined, and its elimination often requires a non - standard, individual approach. A clinical example of a successful laparoscopic clipping of the inferior mesenteric artery performed to eliminate type II endolics is presented.

A survey of 256 patients with lungs’ cavities - 211 (82.4%) men and 45 women aged 16 to 85 years was carried out. The following diagnoses were established: lung abscesses, peripheral lung cancer with disintegration, cavernous tuberculosis, true bronchogenic lung cyst, aspergilloma, emphysematous cysts and bullae, pulmonary echinococcosis. All patients underwent a complex radiation examination of the lungs, bronchoscopy with various types of biopsies, followed by bacteriological, cytological, and morphological studies of the biopsy material, as well as transthoracic aspiration biopsy. Sanitation bronchoscopy was performed in 146 patients with lung abscesses. Based on only X-ray methods, it was possible to establish the nosological form of the lung cavity formation in 204 patients (79.7%). With the combined use of radiation diagnostic methods, bronchoscopy with various types of biopsies, and transthoracic puncture biopsy followed by morphological examination of the biopsy material, the correct diagnosis was established 100% of patients. In patients with lung abscesses who received NO-therapy in complex treatment, there was a significant decrease in clearing the abscess cavity.

The study aimed to evaluate the clinical effectiveness of laser puncture of biologically active points in the treatment of metabolic diseases of the eyes, methods of its application in the pathology of the anterior segment of the eye and the macular zone. Laser puncture of biologically active points has several advantages over acupuncture and their electrical stimulation: there is no need for acupuncture needles, which eliminates the pain factor during treatment, excludes the possibility of transmission of infection, wider indications for use. The procedure is safe and well - tolerated. The results were evaluated according to patient complaints, visual acuity, clinical picture, and the level of the critical flicker frequency of the light source. In most cases, an improvement or stabilization of the pathological process was noted.

The quality of medical care is directly dependent on timely reliable instrumental diagnostics and treatment, which is directly related to the provision of military medical organizations with modern medical equipment. The authors propose economically sound calculation methods for planning purchases, use, and write - off of medical equipment. The described methods and the calculations made will help to make the right management decisions on the issues of medical supplies.

The problem in the treatment of coccygeal epithelial passages is the choice of the method and method of rehabilitation of patients in the postoperative period. When applying primary sutures to the wound after excision, there is a high proportion of complications and relapses. The use of the technique of suturing the edges of the skin to the bottom of the wound is accompanied by an increase in the healing time up to 1.5 months or more. Open management of a postoperative wound is characterized by a minimal percentage of relapses, but its healing time increases from several months to a year. Plastic surgery with wound closure with a displaced flap is not widely used. Therefore, in each specific case, the most optimal tactical and technical approach is chosen.

An analysis of the effectiveness of the use of nitrogen - siliceous thermal baths of the Nizhneparatunsky springs combined with the Medvezhye Lake peloid in the Kurgan region in 112 patients with lumbosacral radiculopathies is presented. It was found that with the combined use of nitrogen - siliceous thermal baths and sulfide - silt mud, the time to achieve the expected positive effect on the part of the injured limb is reduced. This is confirmed by a significant decrease in the magnitude of the current required for a pronounced but painless muscle contraction during electroneuromyostimulation by 6-8 mA for the full course of treatment.

The article presents a brief biography and main directions of scientific activity of the Hero of Socialist Labor, laureate of the USSR State Prize, Honored Scientist of the RSFSR, Professor Major General of the Medical Service Veniamin Vasilyevich Volkov (1921-2019).