Vol 340, No 2 (2019)

Articles

Problems and perspectives of organization of medical rehabilitation in a military health resort according to the CMI program

Dolgikh S.V., Ostroukhov A.E., Kirsanova A.A., Krupnov M.G.

Abstract

The organization of medical rehabilitation of patients in sanatorium-and-spa organizations of the Ministry of Defense of the Russian Federation after treatment under in-patient conditions, including in the framework of compulsory medical insurance, is outlined. The characteristic of its phase is given. The positive dynamics of the number of patients who underwent medical rehabilitation in the sanatoriums of the Ministry of Defense has been shown (from 2012 to 2017, the growth is 24 times), which is facilitated by the developed material and technical base, technical equipment, the introduction of innovative technologies, and the readiness of the medical staff of military health resorts. The experience of the military sanatorium «Volga» on medical rehabilitation of patients not related to the military department has been analyzed in the framework of compulsory medical insurance. The perspectives of work in this direction are shown, which is manifested in the receipt of additional financial resources, the acquisition of relevant experience with patients, improving the use of the hospital bed facility, the prestige of military medical organizations.
Voenno-medicinskij žurnal. 2019;340(2):4-11
pages 4-11 views

Clinical and economic rationale for the use of complex antibacterial lymphatic and nitrogen monoxide therapy for peritonitis caused by diseases and injuries of the upper urinary tract

Musailov V.A., Krainyukov P.E., Esipov A.V., Achkasov E.E.

Abstract

A clinical and economic analysis of the use of complex lymphatic and nitrogen monoxide therapy for peritonitis caused by diseases and injuries of the upper urinary tract was carried out. ABC analysis showed that the treatment of the abdominal cavity with nitrogen monoxide and lymphotropic administration of antibiotics is the least expensive technologies. The analysis of «cost minimization» revealed the possibility of a significant reduction in the cost of treating one case of peritonitis through the use of complex nitrogen monoxide and lymphatic therapy. The «cost-effectiveness» method has demonstrated that the use of complex nitrogen monoxide and lymphatic therapy is 1.3 times more economical and 30% more effective than the «classical» treatment regimen.
Voenno-medicinskij žurnal. 2019;340(2):11-17
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Comparative analysis of the creation of antidotes of organophosphorus toxic substances in Russia and abroad. The article is devoted to a comparative analysis of the creation of means of prevention and emergency treatment of organophosphorus poisoning in Russia and abroad. Antidote drugs traditionally used for intoxication with anticholinesterase poisons, as well as new-generation drugs developed abroad are considered. Attention is focused on compounds from the group of reversible inhibitors of cholinesterase, benzodiazepines, «bio-cleaners» as a means of preventing poisoning, on some new dosage forms of antidotes. Modern schemes of etiotropic and pathogenetic therapy of intoxication with organophosphorus toxic substances, based on the use of cholinesterase reactivators, cholinergic antagonists, benzodiazepines, are evaluated. The promise of using several agents, such as glutamate receptor blockers, for stopping toxic seizure syndrome, as well as drug combinations of various pharmacological groups, was noted

Yudin M.A., Chepur S.V., Fedonyuk V.P., Subbotina S.N., Kolesnikov A.M., Sazonova A.V., Shchemeleva N.I., Pavlova L.V., Tyunin M.A.

Abstract

The article is devoted to a comparative analysis of the creation of means of prevention and emergency treatment of organophosphorus poisoning in Russia and abroad. Antidote drugs traditionally used for intoxication with anticholinesterase poisons, as well as new-generation drugs developed abroad are considered. Attention is focused on compounds from the group of reversible inhibitors of cholinesterase, benzodiazepines, «bio-cleaners» as a means of preventing poisoning, on some new dosage forms of antidotes. Modern schemes of etiotropic and pathogenetic therapy of intoxication with organophosphorus toxic substances, based on the use of cholinesterase reactivators, cholinergic antagonists, benzodiazepines, are evaluated. The promise of using several agents, such as glutamate receptor blockers, for stopping toxic seizure syndrome, as well as drug combinations of various pharmacological groups, was noted. K e y w o r d s: organophosphate po
Voenno-medicinskij žurnal. 2019;340(2):18-26
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Voenno-medicinskij žurnal. 2019;340(2):26
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Features of providing surgical treatment to victims with bile duct trauma in the hospital

Romashchenko P.N., Maistrenko N.A., Pryadko A.S., Aliev A.K.

Abstract

The results of examination and treatment of 66 patients with lesions of the bile ducts were studied, the effectiveness of their elimination during surgical interventions-reconstructive-reconstructive (43.5% of patients), reconstructive (35.5%) and external drainage (21%) was evaluated. A software approach has been developed to provide surgical care for patients with bile duct injury, considering the current requirements for medical provision of the Armed Forces. Realization of the presented program allows to provide timely diagnostics of damages of bile ducts and to minimize the number of postoperative complications. It has been established that a rational approach to reducing the number of lesions of the bile ducts is their prevention by mandatory observance of the procedure of operative intervention on the organs of the upper floor of the abdominal cavity.
Voenno-medicinskij žurnal. 2019;340(2):27-35
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Features of preoperative planning of patients with degenerative-dystrophic diseases of the hip and knee joints

Lychagin A.V., Gritsyuk A.A., Gasymov A.S., Gasanov Y.S., Kryukov E.V., Brizhan’ L.K., Buryachenko B.P., Varfolomeev D.I.

Abstract

The article presents the results of a comparative analysis of the main medical and statistical characteristics and comorbid background of 1782 patients with coxarthrosis who were admitted for hip arthroplasty and 2482 with gonarthrosis for knee arthroplasty. With both sites of arthrosis, women were more common than men (with coxarthrosis, about 2 times, with gonarthrosis, almost 4 times). In coxarthrosis, the proportion of men with comorbidities was higher than that in gonarthrosis, in women - an inverse relationship. In both cases, hypertension and obesity were the most common comorbidities. In young patients, the best results were obtained with the use of minimally invasive techniques - short legs with coxarthrosis and single-denture prostheses with gonarthrosis, which must be considered when planning the provision of high-tech medical care.
Voenno-medicinskij žurnal. 2019;340(2):36-45
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Predictors of gastrointestinal neoplasia (Literature review)

Lantukhov D.V., Khalimov Y.S., Shcherbak S.G., Vologzhanin D.A., Kamilova T.A., Slesareva E.G.

Abstract

Gastrointestinal neoplasia is one of the most serious problems of modern medicine. Colorectal cancer ranks third in the overall structure of malignant tumors and accounts for 10% of all cancers. At the same time, in every third patient at the time of diagnosis, a common form of the tumor process is already noted. The main reason for this situation is the extremely low detectability of the tumor in the early stages of development. There is a clinical need for predictive biomarkers to enable the earliest and more accurate identification of patients with a high risk of disease recurrence and to prescribe the optimal treatment for them. The review systematizes information about the used and promising diagnostic indicators that allow early detection of colorectal cancer, determine the prognosis of the disease, as well as assist in choosing the most effective therapy.
Voenno-medicinskij žurnal. 2019;340(2):45-51
pages 45-51 views

Low doses of aspirin and gastrointestinal complications (Literature review)

Moroz E.V., Chernetsov V.A., Kryukov E.V.

Abstract

Low-dose aspirin has been and remains one of the main antithrombotic agents used to prevent cardiovascular accidents. However, its use is associated with a wide range of complications from the gastrointestinal tract, including such a dangerous pathology, as ulcers and bleeding. According to statistics, while receiving low doses of aspirin, dyspepsia occurs in 30, gastric erosion in more than 50, gastric and duodenal ulcers in about 7, and «large» gastrointestinal bleeding in 0.6% of patients. In the presented review, the pathogenesis of these complications, their clinical and endoscopic characteristics, epidemiology and risk factors, including the role of Helicobacter pylori, are considered. Low-dose aspirin and H. pylori have been shown to be independent factors for ulcers and gastrointestinal bleeding. The advantages and disadvantages of the main methods of preventing side effects while taking low doses of aspirin are discussed: the use of proton pump inhibitors, anti-helicobacter therapy, the use of rebamipide. When prescribing aspirin as an antithrombotic agent, one should be aware of the danger of development in patients with risk factors for life-threatening bleeding and the need for their prevention.
Voenno-medicinskij žurnal. 2019;340(2):51-57
pages 51-57 views

Evaluation of effectiveness of different variants of normobaric hypoxic training to restore the functional capabilities of the person

Eroshenko A.Y., Golovinova V.Y., Ivanov A.O., Groshilin V.S., Kochubeinik N.V., Sklyarov V.N., Stepanov V.A.

Abstract

A comparative assessment of the effect of various normobaric hypoxic training on the state of the physiological functional capabilities of a person has been carried out. The studies involved 30 men who had signs of deficiency of functional organism reserves. In the group 1 (15 people), normobaric hypoxic training was used in the standard mode: 15 daily hypoxic breathing procedures for 40 minutes. During the initial 4-5 procedures, the oxygen content was gradually reduced from 17 to 13.5%, after which it was not changed. In group 2 (15 people), the original hypoxic training was used: 15 daily 40-minute inhalations of argon-containing respiratory hypoxic mixture of unchanged composition: [Ar]=35%, [O2]=11-12%, nitrogen - the rest. Because of the training in group 1, the increase in the integral index of functional capabilities averaged 15% from the initial level, in group 2 - about 28%. Also, in group 2, more significant positive changes were observed on the part of the indices of samples with breath-holding and physical activity. Thus, argon-hypoxic training is an effective and safe method of expanding human functional capabilities, which allows us to offer its widespread use in the system of medical and psychophysiological support of military personnel.
Voenno-medicinskij žurnal. 2019;340(2):58-65
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Voenno-medicinskij žurnal. 2019;340(2):65
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Dependencies of psychophysiological status, immunity and blood pressure in the crew with arterial hypertension in the Far North

Zakrevskii Y.N., Shevchenko A.G., Butikov V.P., Gertsev A.V.

Abstract

A total of 54 military personnel aged 30-45 years (average 34±8.4 years) were divided into 2 groups: 1st (n=34) - specialists of surface crews with identified hypertension and asthenoneurotic disorders; Group 2 (n=20) - military with hypertension without neurotic disorders (control). In the 1st group, the presence of regulatory dysfunctions in the neuropsychological adaptation system, the supersegmental area of the autonomic nervous system, and the immune system, affecting the clinical course of hypertension, was revealed. The nature of regulatory dysfunctions is due to impaired psychological and psychophysiological status (high anxiety, depression and stress-mediated reactions), autonomic regulation (low levels of b-endorphin, sympathicotonia and autonomous stimulation), changes in the cytokine immunity pool (increased levels of pro-inflammatory and decreased anti-inflammatory cytokines ) and the functioning of the cardiovascular system (high level of average daily systolic and diastolic arterial pressure during the day and night periods).
Voenno-medicinskij žurnal. 2019;340(2):66-70
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Voenno-medicinskij žurnal. 2019;340(2):70
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Methodical approaches to improving the level of medical knowledge in military personnel

Zholus B.I., Butakov S.S., Remmer V.N.

Abstract

The need for measures of individual prevention of diseases, injuries and other health disorders of servicemen is noted. A «Memo to a soldier for the protection of life and health» has been developed, which is recommended to be given to soldiers during the first days of service. The characteristics of the structure and content of the memo, the elements of its decoration, the interpretation of practical significance are given. It was proposed to introduce into the training programs in educational organizations of the Ministry of Defense a study of the basics of military hygiene.
Voenno-medicinskij žurnal. 2019;340(2):71-73
pages 71-73 views

Early complications of endovascular prosthetic abdominal aortic aneurysm.

Esipov A.V., Pinchuk O.V., Obraztsov A.V., Yamenskov V.V., Zharikov S.B., Abrosimov A.A.

Abstract

The article summarizes the own experience of 46 operations of endovascular prosthetic abdominal aortic aneurysm. Early complications, their causes and results of treatment were evaluated. A clinical example of the surgical correction of complications in a patient after endovascular treatment of abdominal aortic aneurysm is given. Despite the small invasiveness of the operation of endovascular correction (EVAR), there remains a potential risk of complications associated with the severity of the patient’s initial condition and associated diseases. This requires the adoption of preventive measures and careful dynamic observation in the postoperative period. Timely diagnosis and assessment of the complications that have arisen, as well as a strictly individual approach to treatment, allow achieving optimal results of EVAR.
Voenno-medicinskij žurnal. 2019;340(2):73-75
pages 73-75 views

Active detection, treatment and medical rehabilitation of patients with chronic liver diseases in a multidisciplinary hospital

Pavlov A.I., Shakula A.V., Shchegol’kov A.M., Chernyshev A.V.

Abstract

The structure of chronic liver diseases was studied in gastroenterological patients admitted to a multidisciplinary hospital. These diseases were detected in 23% of cases. In the structure of chronic hepatitis, the share of alcoholic hepatitis is 37%, non-alcoholic steatohepatitis - 26, autoimmune hepatitis - 4, viral hepatitis - 22, other hepatitis - 11%. Cryptogenic liver diseases, the etiology of which could not be determined, were diagnosed in 13% of patients. The tactics of treatment of chronic liver disease were determined depending on the extent of its damage. An individual approach to the management of this category of patients can significantly improve the efficiency of diagnosis, treatment and medical rehabilitation. In this regard, an important task is the development of personalized programs for the detection, treatment and rehabilitation of patients with liver diseases.
Voenno-medicinskij žurnal. 2019;340(2):75-77
pages 75-77 views

Surgical correction of «physiological» astigmatism in people with visually intense work with myopia

Ovechkin I.G., Yudin V.E., Budko A.A., Belikova E.I., Kozhukhov A.A., Pozharitskii M.D., Shakula A.V.

Abstract

It has been determined that the excimer-laser correction of «physiological» (0.5 D) astigmatism in patients with visual-intensive work with myopia provides a significant improvement in ophthalmic-ergonomic and clinical-subjective indicators of the visual system. At the same time, an increase in the level of visual performance is noted in the most difficult conditions for presenting test information associated with a lack of time.
Voenno-medicinskij žurnal. 2019;340(2):77-79
pages 77-79 views

Experience in the use of endovideosurgical technologies in the garrison hospital

Lomakin D.N., Redkozubov A.A., Skachkov O.A., Margaryan A.S., Ushakov M.V.

Abstract

The article highlights the possibilities of application and the prospects for the development of endovideosurgical technologies in the conditions of the garrison military hospital, which helps to improve the quality of medical care for surgical patients. The use of laparoscopy allows to activate the patient faster in the early postoperative period, reduce the number of infections in the surgical area and reduce the hospital stay.
Voenno-medicinskij žurnal. 2019;340(2):80-81
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From the history of the Tarkhovsky military health resort

Yaremko V.I., Cherkasova V.L., Derevyanko S.V., Korovin A.E.

Abstract

Presented information about the history of the health resort «Tarkhovsky» of the Ministry of Defense of the Russian Federation. Reflects the history of the health resort from 1933 to the present. Its unique location is described in Sestroretsk, near the Gulf of Finland and Sestroretsky Spill Lake. It is told about the healing effects of sea air, medical procedures on the health of servicemen, pensioners of the Ministry of Defense, their family members, and the civilian personnel of the Ministry of Defense. In 2018, the branch «Tarkhovsky health resort», which is part of the Zapadny Sanatorium and Resort Complex, celebrated 85 years since its foundation.
Voenno-medicinskij žurnal. 2019;340(2):82-86
pages 82-86 views

On the medical library of the Kronstadt Naval Hospital

Roskostov M.V., Kalganova I.B.

Abstract

A brief essay on the history of the library of the Kronstadt Naval Hospital - one of the unique collections of medical publications of the XVIII-XX centuries. Currently, the library has two funds: medical and fiction. The medical fund has more than 13 thousand books, starting with the editions of the XVIII century. When working with the foundation, the authors of the article managed to reconstruct the composition of the personal libraries of some of the hospital doctors. Modern doctors find in the library descriptions of treatments that have not lost their relevance. Today the library of the Kronstadt Naval Hospital is of interest both to medical readers and researchers of the history of Russian medicine.
Voenno-medicinskij žurnal. 2019;340(2):86-88
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Voenno-medicinskij žurnal. 2019;340(2):88
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Ofitsial'nyy otdel

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Voenno-medicinskij žurnal. 2019;340(2):89-90
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Voenno-medicinskij žurnal. 2019;340(2):91-93
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Research-to-practice conference «Cross-disciplinary approaches to the study of mental health of a person and society»

Shamrei V.K., Marchenko A.A., Kurasov E.S.

Abstract

Within the framework of the research-to-practice conference «Cross-disciplinary approaches to the study of mental health of a person and society», plenary and sectional sessions were held on military and extreme psychiatry. The conference was attended by leading scientists in the field of mental health. The need for a broader implementation of interdisciplinary approaches to the study of the mental health of a person and society, the integration of efforts of various specialists (psychiatrists, psychologists, psychophysiologists, etc.), as well as scientists of various specialties (in the field of neuroscience, biophysics, neurogenetics, computer science) to achieve breakthrough results in solving this problem.
Voenno-medicinskij žurnal. 2019;340(2):94-96
pages 94-96 views

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