Vol 5, No 4 (2019)

Sarcoidosis is an urgent problem for the military medical service of various law enforcement agencies. In recent years, there has been an increase in the incidence of sarcoidosis among young people undergoing military service and the creation of a unified algorithm of medical care for this contingent is important. The publication presents the epidemiology of the disease, known risk factors, and triggers for the development of sarcoidosis in military sailors. The most important factors associated with a high risk of sarcoidosis are: high dustiness of the air, diesel and rocket fuel vapors, and various types of radiation. In military personnel, the second stage of sarcoidosis is most common. The recurrence rate of the disease is 20%, and the factors associated with the recurrent course of sarcoidosis in military personnel are — the age of more than 35 years; the presence of clinical manifestations of sarcoidosis (cough, weakness, shortness of breath); forced lung capacity <85%; a history of systemic glucocorticosteroids. The article presents the recommended algorithm and methods for examining patients with sarcoidosis. It is noted that the main point is the mandatory morphological verification of the process in the military. Special attention is paid to the treatment of sarcoidosis in the publication. It is noted that, given the high frequency of remissions, treatment is not indicated for stage I, as well as for asymptomatic patients with stages II and III of sarcoidosis, provided that only mild disorders of the ventilation and diffusion function of the lungs are present. All patients with sarcoidosis are subject to active medical supervision.

Over the last decade, due to considerable expansion and energized activity of the Russian Navy in the areas of the World Ocean, the number of long sea trips of Northern Fleet ships has significantly increased. Long-term occupancy in the off-shore maritime zone, in different geographic areas — from the Northern Sea Route to Africa hold the Joint Strategic Command of the Northern Fleet and Medical Service to considerable organizational measures and decisions to ensure the preservation of health of the military personnel during the whole period of cruise, guaranteed qualified and specialized medical care in cases of acute diseases, medical emergencies and injuries. Organizational decisions were made in order to strengthen ship forces in an off-shore maritime zone by means of staff expansion with additional medical specialists and retrofitting with modern medical equipment, and specialized treatment extension what affects the morbidity rate and surgical treatment outcomes at sea.

This paper will discuss the perspectives of the marine medicine in the Crimean region, outlining key achievements from the collaboration between the Medical Academy Named after S. I. Georgievsky (Simferopol) and Sanatorium Sudak. As a result integral diagnostic approach of navy military personnel was provided by the research team ensuring that early most physical and psychic functional changes are revealed in time. Given approach with the main focus on most efficient measures is aimed to provide person-oriented rehabilitation techniques in terms of health resort accounting for the specific professional activity. Current research consists of a series of examinations made in accordance with the standardized methods for the functional state examination followed by the medical and psychological rehabilitation recommended by the Ministry of Defense of the Russian Federation as well as own approaches were applied for the assessment of adaptive responses. At this stage examination of the submarines’ crew members that was carried out during the entire health resort rehabilitation period suggests that for differentiation approach to be successful the assessments should consider the condition of the autonomic nervous system and highly sensitive parameters of the electroencephalographic recordings. As comparison of current standards and recommendations of medical and psychological rehabilitation with the efficiency of electroencephalography and heart rate variability recordings along with the psychological tests suggests that the latter provide better insights into the efficiency of rehabilitation and they should be included into the examination protocols. Assessment and further appropriate correction of microelement status should be also implemented as it ensures better functional and adaptive capacity.

Introduction. Excessive stress on the functional reserves of the body of military personnel can lead to persistent health disorders, disability and dismissal from the Armed Forces of Russia. Aim. Compare the dismissal for health reasons in the military personnel of the Navy of Russia and the Russian Armed Forces in 2003–2018. by categories of military personnel. Material and methods. We conducted a statistical analysis of medical reports on the health status of personnel and medical service activity according to Form 3/MED in military units with a sample comprising about 60% of the total number of military personnel of the Russian Armed Forces and the Navy served from 2003 to 2018. The results and their discussion. Dismissal for health reasons in officers of the Russian Navy over 2003 to 2018 was 15,90±1,36, officers of other branches of the Russian Armed Forces — 7,98±1,10‰ (p<0,001); contract servicemen — 6,82±0,57 and 3,92±0,32, respectively (p<0,001); conscripts — 33,38±1,79 and 17,57±1,19, respectively (p<0,001); women soldiers — 23,01±3,34 and 9,14±1,37‰ (p<0,01). There were no significant differences in the nomenclature of disease blocks that caused dismissals in the categories of military personnel of the Russian Navy and the Russian Armed Forces. Higher dismissal levels within disease blocks indicated higher intensity of professional work and increased demands to the health status of the Navy servicemen compared to those from other branches of the Armed Forces. As a rule, dismissals of military personnel of the Russian Navy and the Russian Armed Forces were due to diseases of the circulatory system (ICD-10 Chapter IX), diseases of the digestive system (Chapter XI) and neoplasms (Chapter II). At the same time, some features of the structure of dismissals for health reasons were identified in the military personnel by categories. Conclusion. Accounting for and prevention of leading diseases that caused dismissals due to health reasons will contribute to improving the health of military personnel. It is necessary to focus the attention of the Russian Navy on a healthy lifestyle and increased physical activity.

Introduction. The increase in tension and complexity of the naval personnel work is naturally accompanied by an increase in the risk of formation of unacceptable functional states and a critical decrease in professional reliability. Timely detection and prevention of such states is impossible without the implementation of dynamic monitoring of naval personnel working capacity in the process of professional activity. Purpose of research — substantiation of complex technology of functional state and working capacity control of naval personnel. Materials and methods. During performance of work 215 ship experts of various profile of activity were examined. The studies were carried out using an automated functional state screening control system designed on a modular basis and implemented on a number of Navy orders. The results of research. The systems of dynamic control available at the Navy are an effective tool for early detection of borderline functional States of seafarers; determination of the working capacity stage in which the specialist is currently located; development of recommendations for the implementation of corrective measures. However, in real life, these systems are practically not used, there are no guiding documents regulating their application. Implementation of such automated systems on other ship projects requires adaptation and improvement of such systems. In addition, the Navy has no technical means to monitor the functional status of personnel directly during the performance of particularly complex tasks, the struggle for survivability and other extreme situations. Conclusion. The basic concept of screening control and monitoring of the naval personnel functional state in the process of professional activity is proposed.

Introduction. The use of internal resources to preserve professional longevity and constructive occupational genesis is becoming more and more popular in the field of specialists in extreme professions. Goal. Finding the conditions for the development of resiliency will allow for effective professional-psychological selection, medical and psychological support for employees of various activities. The work considers the resiliency within the framework of the scientific school of the academician of the Russian Academy of Education V. S. Mukhina. Materials and methods. To identify the conditions for the development of resiliency, male subjects of various professional groups took part in the study, whose daily activities at the substantial level included an extreme component in three areas: biological (study of psychophysiological status), psychological (individual-personality and socio-psychological characteristics) and social (demographic and social status elements). Results. One of the conditions for the development of the individual’s resiliency in the field of extreme types of labor is a positive attitude to the activities carried out with the support of family members and close friends. Resourcefulness in professional activity is ensured by «supraconscious» processes of conscious operations, which were developed earlier as unconscious mechanisms and attitudes of conscious actions given to an individual and allowing to perceive the circumstances of labor activity as standard. The reality of the internal space of the personality of resilience employees, according to factor analysis, is reflected in socialization, adaptability, mobilization, self-regulation and stability in the process of fulfilling everyday functional duties containing an extreme component, and is regulated by energy, perceptive, motivational, communicative and emotional-activity levels.

The present paper represents main periods of military and medical training in the Crimean Medical University named after S. I. Georgievsky from 1945 to 2010. The first period (1945–1970). Training of army medical officers for Army Forces was carried out at the Military Arts Division. In 1960, due to reduction in Army Forces by 1200000 servants the division was dissolved. From 1960 to 1968, training in Crimean Medical Institute was not conducted. In 1968, the Military Arts Division was restored and to 1970, the training of army medical officers for Army Forces was continued. The second period (1970–1991). In 1970, the Naval Division was found and training of surgeons for the Navy was started. The third period (1991–2010). The Naval Division was renamed in the Military Arts Division where training of army medical officers for Army Forces was started. The division was further changed its name twice to the Division of Extreme and Military Medicine and the Division of Disaster Medicine. In 2010, the government of Ukraine made a decision regarding cutbacks of the Division of Disaster and Military Medicine in the Crimean Medical University. In the same year, the last graduation of army medical officers was held. Throughout the military training period, of the more than 7000 graduates of the Crimean Medical Institute (University) were certified as reserve officers of Medical Service for the Navy and of the more than 8000 graduates — as reserve officers of Medical Service for the Armed Forces.

The article is devoted to the outstanding naval surgeon professor Mikhail Luschitsky, head of the department of naval and hospital surgery of the Military medical Academy. S. M. Kirov (1973–1986 biennium), general-major of the medical service. Mikhail Alekseevich graduated from the Naval medical Academy in 1941 and was sent to the Pacific fleet. For participation in the war with militaristic Japan will be awarded the order of the red Star. From 1951 to 1958 he served in the Kronstadt naval hospital as head of the surgical Department. Kronstadska school of naval surgeons laid the future surgeon general of the navy and head of the department of naval and hospital surgery professor, the general-major of medical service M. A. Luschitsky to go the fundamental basis of his future scientific and pedagogical activity. In the period from 1958 to 1961, he, being an adjunct of the department of naval surgery, prepared his thesis «Surgical treatment of frostbite 3–4 degrees, combined with radiation sickness», for the scientific value of which the Scientific Council of the Academy awarded him the degree of doctor of medical Sciences. From 1973 to 1986 Mikhail Alekseevich was the head of the department of naval and hospital surgery, where his talent of a great teacher, surgeon and organizer was fully manifested. He created his own unique school of naval surgeons. Mikhail Alekseevich is the author of 146 scientific works, he was twice elected Chairman of the Surgical society of Pirogov. Under his leadership, 7 doctoral and 18 master’s theses were prepared and defended. He retired in 1986. Mikhail Alekseevich died on March 10, 1999.