Vol 339, No 2 (2018)


Assessment of the effectiveness of military medical organizations providing primary health care

Rusev I.T., Karailanov M.G., Fedotkina S.A., Prokin I.G., Borisov D.N.


The purpose of the study was to determine the organizational and methodological approach to assessing the effectiveness of military medical organizations in providing primary health care in outpatient settings on the basis of an analysis of literature data. In modern conditions for military medicine, the important and yet unsolved problem remains to assess the effectiveness of the medical organization. The management of the medical service is impossible without determining the priority goals, indicators of their achievement and parameters of the effectiveness of the use of financial, material and human resources. This makes it necessary to develop a methodology for assessing the effectiveness of medical care, which will allow to ensure the interrelationship between management and planning processes, as well as to solve the practical tasks of developing military medicine. In assessing the effectiveness of primary health care in outpatient settings, there is no single methodological approach to its study, and therefore it is necessary to select indicators, including priority ones, taking into account modern conditions. There is the possibility of an integral evaluation based on the use of a set of methods of social and hygienic research.
Voenno-medicinskij žurnal. 2018;339(2):4-10
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Voenno-medicinskij žurnal. 2018;339(2):10-10
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Values of the intima-media complex of carotid arteries as a reflection of the evolution of high normal blood pressure

Kryukov E.V., Potekhin N.P., Fursov A.N., Chaplyuk A.L., Sarkisov K.A., Makeeva T.G., Zakharova E.G.


The clinical and diagnostic value of the intima-media complex of the carotid arteries was studied as one of the early criteria for the evolution of high normal blood pressure to arterial hypertension as a nosological form. Medical records of 190 persons are analyzed. The subjects were divided into two groups: the first group included 137 persons with the carotid intima-media complex of less than 0.9 mm, the second group consisted of 53 patients with this complex equal to or more than 0.9 mm. Factor analysis showed that of the five factors in persons of the second group in three high factor load showed the sign «duration of high normal blood pressure». The time sign did not «play» in any factor of the first group. In persons of the second group, the factor of «blood pressure» has the leading position in its significance, the number of risk factors for cardiovascular diseases is more diverse and their factor load is more pronounced than in persons of the first group. Cardiorenal interrelations begin to appear in persons with high normal arterial pressure even at normal values of the intima-media complex of carotid arteries, and in the second group, signs that reflect renal functions have entered virtually all symptom-complexes. The type of intima-media complex of carotid arteries and rigidity of blood vessels are influenced by the type of diurnal rhythms of arterial pressure, especially in the second group - «non-dipper». An increase in the size of the intima-media complex of carotid arteries in persons with prehypertension may be indicative of the transformation of functional vascular changes into organic vessels, followed by the formation of arterial hypertension as an independent nosological form.
Voenno-medicinskij žurnal. 2018;339(2):11-20
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Diagnosis and treatment of chronic prostatitis: the current state of the problem

Myagkov Y.A., Lototskii M.M., Myagkova A.Y.


Chronic prostatitis is a pluricausal disease, one of the frequent, clinically and socially significant diseases that affect young and middle-aged people. At the heart of this is a proven process of liberation. Factors that reduce the quality of life in chronic prostatitis include premature ejaculation, erectile dysfunction and infertility. When choosing the tactics of treatment, one should rely on the traditional classification of prostatitis NIH-NIDDK (1995), but the use of the UPOINT classification allows for additional detailing of categories of prostatitis and to achieve better results in treatment. Antibiotic therapy is prescribed in cases of acute and chronic bacterial prostatitis and with empirical therapy of chronic pelvic pain syndrome in the presence of clinical and immunological signs of infection. Treatment of chronic prostatitis should be complex (a wide range of medicines and non-medicinal methods). Inclusion of methods of physiotherapeutic (non-drug) treatment into the complex of therapeutic measures allows to significantly reducing the number of medicinal preparations, as well as to increase their effectiveness.
Voenno-medicinskij žurnal. 2018;339(2):20-28
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Voenno-medicinskij žurnal. 2018;339(2):28-28
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Varicella in military personnel: clinical features of recent decades

Makhnev M.V.


Materials of surveys for the last 25 years of 1,612 servicemen suffering from varicella are presented. The clinical features of the periods of the disease, the structure of the severity of its course and complications were studied. The characteristic manifestations of the prodromal phase of varicella were revealed. It is shown that the varicellous enanthema can often occur in places not available for direct pharyngoscopy. None of the patients had windmill pneumonia, encephalomeningitis, and other specific complications. Varicella usually presented with acute onset, followed usual pattern, without serious complications and deaths. In 72% of patients she debuted with fever and/or asthenovegetative syndrome. There were mild signs of damage to the upper respiratory system, enanthema and lymphadenopathy, whose frequency increased with increasing severity of the disease. Lesions of the respiratory system had a combined aetiology: some of the symptoms were due to the action of the causative agent of varicella, others - viral and bacterial mixed infections, common in military collectives.
Voenno-medicinskij žurnal. 2018;339(2):29-36
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Lines of development of ergonomic support for the development of military aircraft

Zhdanko I.M., Naichenko M.V., Osipov V.R., Abrashkin D.A.


The definition of ergonomic support for the creation of military aircraft is given, and the need for its emergence is justified. The order, stages and main tasks of ergonomic provision of creation of aviation equipment samples are given. The problems, structure and organization of work on the ergonomic provision of the creation of military aircraft in industry are revealed. The directions of the development of ergonomic support for the creation of this technique are given. The importance of forming a system of ergonomic support for the creation of military aviation equipment, training personnel in the field of ergonomics and the role of ergonomics specialists in ensuring its functioning are emphasized.
Voenno-medicinskij žurnal. 2018;339(2):37-44
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Influence of the opticokinetic and statokinetic effects on the spatial orientation of the aviation profile operators

Blaginin A.A., Sinelnikov S.N., Lyashed’ko S.P., Glushkov R.S.


The effect of the opticokinetic and statokinetic effects on the functional state of the organism, the spatial orientation and the quality of the performance of the operator activity is estimated. In order to provide statokinetic effects, the vestibular sample of OR-10, the opticokinetic effect, was simulated in the opticokinetic drum using virtual reality glasses. The data obtained suggest that the statokinetic effect causes a more pronounced change in the spatial orientation process. Opticokinetic effects, however, have the greatest impact on the quality of operator activity.
Voenno-medicinskij žurnal. 2018;339(2):44-49
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Voenno-medicinskij žurnal. 2018;339(2):49-49
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Analysis of weight and volume characteristics of the norms for the supply of medical equipment to military units and organizations of the Armed Forces

Levchenko V.N., Likhogra I.A., Shestaev K.A.


Calculating the weight and volume of medical equipment plays an important role in planning the provision of medical equipment for the Armed Forces. The adoption of new medical supplies for supply requires the recalculation of the weight-volume characteristics of the existing supply standards. The article describes the characteristics of modern medical equipment, analysed the weight and volume of the current standards for the supply of medical equipment, taking into account the requirements of the documents regulating complete-time equipment of military units and organizations of the Armed Forces. The technique of recalculation of weight-volume characteristics of supply norms is offered.
Voenno-medicinskij žurnal. 2018;339(2):50-54
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Standardization of maintenance by infusion solutions of a large multidisciplinary military medical organization

Miroshnichenko Y.V., Bunin S.A., Umarov S.Z., Kirillova Y.L.


On the example of a large multidisciplinary medical organization - the S.M.Kirov Military Medical Academy - it is shown that in order to correctly determine the need for infusion solutions necessary for the provision of quality medical care, it is required to predict the dynamics of intake of infusion solutions as accurately as possible based on an analysis of the established habitual practice of infusion therapy and its comparison with the standards of medical care. Also, to rationalize the process of drug provision with infusion solutions in the current economic conditions, a combination of the use of both ready-made and extemporal produced infusion solutions is necessary in medical practice.
Voenno-medicinskij žurnal. 2018;339(2):55-59
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Nanovesicular therapy. Evolution of the conception, the current state and prospectives. Communication 1. Nanovesicular therapy of acute kidney injury

Bel'skikh A.N., Galagudza M.M., Golota A.S., Krassii A.B., Nagibovich O.A.


This article is dedicated to evolution of the concept of nanovesicular therapy, the current state of the method, and its prospectives. The publication is conceived as the first of the series concretizing the method by the example of acute kidney injury treatment. The background of the topic, bibliometrics, terminology, classification, extracellular vesicles structure, methods of vesicles detection, study, production and standardization are considered. The preclinical studies and the only so far clinical trial are analyzed in detail. The conclusion that nanovesicular therapy possesses the obvious translational capacity in the treatment of acute kidney injury is made.
Voenno-medicinskij žurnal. 2018;339(2):60-66
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Voenno-medicinskij žurnal. 2018;339(2):67-67
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Minor cardiac abnormalities: study and evaluation for the purpose of military medical examination

Chaplyuk A.L., Brovkin S.G., Koryakin S.V., Ariskina M.A., Ignatov Y.G., Orlov F.A.


For the purpose of detecting minor cardiac abnormalities, a survey of 583 enrollees at a higher military educational institution was conducted. The presence of this pathology was diagnosed in 14 (2.4%) of the examined enrollee. The prolapse of the anterior valve of the mitral valve, additional chords in the left ventricular cavity, an aneurysm of the muscular part of the atrial septum and a two-folded aortic valve were detected. The expert evaluation was carried out taking into account the presence of concomitant disorders of the function of the organs or body systems caused by connective tissue dysplasia. All these enrollees fulfilled the program of assessing the physical readiness of servicemen and were recognized as fit for entering military university.
Voenno-medicinskij žurnal. 2018;339(2):68-70
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Clinical case of diagnosis of noncompact cardiomyopathy of the left ventricle

Yarosh V.B., Yarovoi Y.S., Sukhoterin A.F., Puchek V.D., Voitenko A.G., Emelyanenko M.V., Steklov V.I., Mershina E.A.


Noncompact left ventricular cardiomyopathy is a rare, genetically determined, poorly understood disease in which the myocardium of the left ventricle consists of two layers - normal and noncompact. A clinical case of diagnosis of non-compact cardiomyopathy of the left ventricle in a man of 21 years with manifestations of the disease in the form of heart failure and rhythm disturbances is given. During the examination, signs of noncompact myocardium were revealed in echocardiographic and magnetic resonance studies. The patient underwent radiofrequency ablation of the source of arrhythmia and prescribed medication.
Voenno-medicinskij žurnal. 2018;339(2):70-74
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Case of a serviceman suffered from damages caused by an imitator of a poisonous substance

Zhirun P.M., Glinin S.V.


A case of a serviceman of suffered from damages caused by an imitator of a poisonous substance is described. The chemical agent of irritating action caused local and general symptoms of intoxication in one of the crewmembers of the infantry-fighting vehicle. After the withdrawal of personal protective equipment and the provision of medical care, the symptom severity decreased. After 2 hours, the patient’s condition was satisfactory. The reasons of this case are considered.
Voenno-medicinskij žurnal. 2018;339(2):74-75
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Features of dental rehabilitation of patients with neoplasms of the maxillofacial region

Kochurova E.V., Nikolenko V.N., Tereshchuk S.V., Demenchuk P.A.


One of the most complicated medical and social problems in orthopaedic dentistry is neoplasm of maxillofacial area. Anatomically functional organization of this area is connected with vital and socially significant functions. The peculiarities of dental rehabilitation of patients with neoplasms of the maxillofacial area consist in the fact that it is possible to achieve the optimal result, taking into account not only the clinical, anatomical and morphological data determining the future orthopaedic structure and material of prosthesis manufacturing, but also identifying the adaptive abilities and the influence of the structural material on the maxillary face region.
Voenno-medicinskij žurnal. 2018;339(2):76-77
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Voenno-medicinskij žurnal. 2018;339(2):77-77
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Branch N 3 of the 3rd Vishnevsky Central Military Clinical Hospital (25 CMCH RSMF) celebrates the 55th anniversary

Esipov A.V., Kharisov A.M., Sukhoterin A.F., Kisenkov G.K.


In November 2017, the 3rd branch of the 3rd Vishnevsky Central Military Clinical Hospital of the Ministry of Defence celebrates the 55th anniversary (until 2009 - the 25th Central Military Clinical Hospital of the Russian Strategic Missile Forces, 25 CMCH RSMF). The hospital was established to provide qualified and specialized medical assistance to the personnel of the units, departments and services of the Russian Strategic Missile Forces Command, servicemen and members of their families. During its existence, the hospital has been repeatedly reorganized and is now a modern medical institution for the provision of qualified and specialized (including high-tech) medical assistance to victims in peacetime and wartime. The article shows the main stages of the development of the hospital and its achievements in 55 years.
Voenno-medicinskij žurnal. 2018;339(2):78-81
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Military medicine in the North Caucasus in the first half of the XIX century

Manyshev S.B.


In the article, based on a large amount of factual material extracted from both published and newly introduced archival materials, a review of the development of the health system in the North Caucasus in the 19th century is given. Appeared in the first half of the XIX century in the region, the Russian troops played a big role in this process. It is during this period that the first specialized medical institutions - hospitals and infirmaries are opened here. Already in the first half of the century representatives of local peoples could receive qualified medical assistance in these institutions. In conclusion, a conclusion is drawn on the great role of the Russian military and military medicine in the development of state medicine in the North Caucasus.
Voenno-medicinskij žurnal. 2018;339(2):81-87
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Bombardment of sanitary trains of the Russian Army by German and Austrian aircraft during the First World war

Karpenko I.V.


The article deals with the issue of bombing by enemy aircraft ambulance trains of the Russian Army during the First World war. The evacuation of the wounded performed by military-sanitary trains was an important part of the medical-evacuation support of the Russian Army. During the war, the bulk of the wounded was evacuated from the theatre of operations to the rear of the country by rail. It is shown that the bombing of military sanitary trains was systematically purposeful and violated the provisions of the Geneva Conference of 1864 on the protection and alleviation of the plight of wounded and sick warriors. The Hague Conventions of 1899 and 1907, remaining for the period of the First World war by acting documents of international law, confirmed these provisions. It was noted that the bombings were carried out, despite the Red Cross marking on the roofs of the cars.
Voenno-medicinskij žurnal. 2018;339(2):87-90
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Minnullin I.P., Fomin N.F., Rostomashvili E.T.
Voenno-medicinskij žurnal. 2018;339(2):91-91
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Voenno-medicinskij žurnal. 2018;339(2):92-92
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Issues on military-field surgery traumatology on the program of the 47th International surgery congress

Bryusov P.G., Samokhvalov I.M., Petrov A.N.


The report on the 47th World Congress of Surgeons, held August 13-17, 2017 in Basel (Switzerland), was presented. The congress brought together more than 2 thousand doctors of various surgical specialties: general, military and vascular surgeons, specialists in surgery for injuries and orthopedic traumatologists, interventional radiologists and specialists in emergency medicine, anesthesiologists and resuscitators. The scientific program considered during the congress was at the junction of many medical specialties, involving not only civilians but also military doctors from all over the world.
Voenno-medicinskij žurnal. 2018;339(2):93-96
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