卷 344, 编号 10 (2023)

The purpose of the study is to develop a new classification of combat mechanical injuries of the ENT organs based on their differentiation in terms of severity, nature, and localization. A comparative analysis of various classifications of combat mechanical damage to the ear, throat and nose was carried out. Based on the systematization of data from archival case histories of ENT-wounded during the Great Patriotic War, local wars and recent armed conflicts, a clinical and topographic classification of ENT injuries was developed, which is based on the presence or absence of bone and cartilage injuries. The proportion of light, moderate, and severe wounds in the structure of combat trauma of the ENT organs was determined. The new classification of mechanical ENT injuries differs from the previous ones in its distinct clinical focus, anatomical and topographic construction principle, and mathematical calculation of the severity of ENT injuries and bruises.

Mine-explosive wounds of the maxillofacial region lead not only to defects in the bones of the facial skull but also to defects in the soft tissues of the face and neck. To eliminate defects during the installation of titanium structures, the problem arises of the adequate wrapping and closing with soft tissues without tension, which is often impossible even with the use of local tissue plasty methods. The tension of the soft tissues undoubtedly leads to the failure of the sutures, the exposure of the plate and traumatic osteomyelitis of the bones of the facial skull. Simultaneous bone grafting of extensive jaw defects using free bone autografts with an included skin cushion is a reliable method for replacing defects in the maxillofacial region. This method allows in a short time to achieve rehabilitation of the patient, improve the quality of life and increase patient satisfaction with the treatment. As an example, a clinical observation of the successful use of a free bone autograft with an included skin pad is given. The use of this method during reconstructive operations reduces the number of postoperative complications.

The Russian military medical services face a pressing issue with pneumonia and lung viruses. Currently, many serious problems in the management of patients with lung lesions have come to the fore – incorrect interpretation, substitution of terms, and wrong treatment tactics are common errors. The publication is devoted to one of the clinical scenarios of severe viral infections – acute bronchiolitis in adults. Algorithms for the diagnosis and treatment of this disease are presented. The article examines patient management tactics and provides recommendations for acute bronchiolitis treatment.

It was found that in the case of a new coronavirus infection, the bactericidal activity of neutrophils was accompanied by inhibition of spontaneous oxygen-dependent activity in all the studied groups of patients, which persisted until the end of the observation. Stimulated oxygen-dependent bactericidal activity was also reduced in all groups, except for the group with lung tissue damage in the amount of about 75%. A decrease in the number of neutrophils involved in the process of phagocytosis was shown in all groups. The percentage of phagocytic neutrophils after a 120-minute incubation in all groups was significantly higher than after a 30-minute incubation, which indicates an activated state of the immune system. The phagocytic number coefficient was significantly below normal values in all groups. The index of completeness of phagocytosis during the entire period of observation was below one. An increase in the microbicidal activity of neutrophils increased the risk of a severe course of the disease.

The experience of combined treatment of eye pterygium with the use of 0.05% cyclosporine eye drops before and after surgery is presented. The proposed complex treatment gives a good effect, a statistically significant reduction in the number of relapses of the disease, and can be recommended for a wide range of ophthalmic surgeons in outpatient practice.

The article provides an analysis of the methods of mass immunization of personnel, the possibility of its application on the scale of the Armed Forces. A list of infectious diseases and toxin injuries relevant to the personnel of the army and navy is presented. Immunity for infectious diseases can be achieved in military personnel only through the use of high-performance methods of mass immunoprophylaxis. The advantages and disadvantages of existing methods are considered. Briefly, data on technical means of mass immunization are given with a description of their capabilities. It has been shown that there is currently no alternative to the use of needleless injectors for mass immunization.

Assessment of acoustic conditions at aerodromes with temporary accommodation of aviation personnel showed that the maximum permissible noise levels were exceeded by 25–35 dB. A survey of aviation personnel under conditions of increased acoustic load revealed sleep disorders in more than 80% of the flight crew. The study of hearing in aviation personnel using audiometry and otoacoustic emission methods showed an increase in hearing thresholds by 4 dB at a frequency of 4 kHz, a decrease in the intensity of the response of otoacoustic emission at the frequency of the distortion product by 3 dB and a delayed evoked otoacoustic emission by 8 dB. The most pronounced hearing changes were found in the delayed evoked otoacoustic emission study. Using the bench modeling method, the results of flight activity and functional reserves under acoustic exposure conditions were obtained, indicating a decrease in the reliability of activity under acoustic load conditions by 21% and functional reserves by 15%. Substantiated proposals for noise protection of flight and engineering personnel by means of collective protection in the versions of workplaces and residential modules.

One of the components of ensuring the activities of military medical organizations is the collection and disposal of generated medical waste. The circumstances of the COVID-19 pandemic have shown the importance of completing this task in a timely and efficient manner. This determines the need for adequate organizational approaches and technical solutions, the creation of tools that allow the disposal of medical and biological waste in compliance with the established sanitary and hygienic and anti-epidemic measures. The article highlights the experience of creating a mobile unit for the disposal of hazardous medical and biological waste, which has passed state, interdepartmental and military tests. The installation is easy to operate, provides reliable destruction of waste to a safe ecological state.

The article presents the results of the analysis of available literary sources covering the issues of epidemiological surveillance in the armed forces of a number of foreign states. It is shown that the features of its organization are due to the climatic and geographical characteristics of potential theaters of military operations, as well as socio-economic and military-political factors. Characteristics of differences in strategic approaches to epidemiological surveillance due to the influence of these factors are given.

The article is devoted to the 80th anniversary of the leading state forensic institution of the Russian Defense Ministry – the 111th Main State Center for Forensic and Forensic Examinations. Currently, this is a multidisciplinary state forensic institution, which conducts all the main types of forensic, forensic psychiatric and forensic examinations. An important area of activity is the work to establish the identity of the unidentified bodies of dead servicemen, performed by the subdivisions of medical forensic and molecular genetic identification. The article also provides information about the historical aspects of the functioning of the institution and its activities at the present stage.