Vol 339, No 6 (2018)


The Vishnevskiy 3rd Central military clinical hospital: experience, high technology and innovation (to the 50th anniversary)

Esipov A.V., Alekhnovich A.V., Frolkin M.N.


June 20, 2018 marks the 50th anniversary of the founding of the Vishnevsky 3rd Central military clinical hospital of the Ministry of Defense of Russia. Today the hospital is one of the leading medical and scientific institutions of the Armed Forces of the Russian Federation. The main medical and scientific directions of his work are cardiosurgery, cardiology, urology, neurosurgery, neurology, combat surgical and therapeutic pathology, early rehabilitation of wounded and sick military personnel, etc. The hospital is a large methodical and educational center of medical service, an institution with rich experience of practical work in conditions of military and peacetime.
Voenno-medicinskij žurnal. 2018;339(6):4-9
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Military-medical examination for cardiovascular diseases in the central military clinical hospital

Shklovskii B.L., Prokhorchik A.A.


The analysis of the work of the therapeutic military medical commission 3 of the CMCH on medical examination of more than 4 thousand military personnel with cardiovascular diseases is presented. The features of the incoming flow of military personnel with cardiovascular pathology are shown in the central military clinical hospital. The acute issues of daily expert work were noted. The increase in the prevalence of risk factors for cardiovascular diseases in persons of conscript age, the increase in the length of service of military personnel in the frame will, in the near future, increase the importance of cardiovascular diseases and the increased attention to this problem at all levels of the medical service in terms of prevention, early detection, timely and adequate treatment, dynamic observation and medical examination of military personnel. Cardiovascular pathology in the expert work of the therapeutic military medical comission of the central military hospital occupies an important place due to the prevalence of these patients in the structure of the surveyed military personnel (more than 50%), the presence of significant morphological and functional disorders of the cardiovascular system, comorbid pathology, in to a significant extent restricting their fitness for military service.
Voenno-medicinskij žurnal. 2018;339(6):9-17
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To the question of presumed consent to posthumous organ donation: legal problems of implementation.

Allamyarova N.V., Sanakoeva E.G.


The article deals with the implementation of human rights in the sphere of postmortem donation and transplantation of organs and (or) tissues in the Russian Federation. The main problems of the functioning of the «presumption of consent» model in the country, in particular, the lack of an effective mechanism for realizing somatic human rights in the sphere of postmortem donation and transplantation, are revealed.
Voenno-medicinskij žurnal. 2018;339(6):17-23
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Voenno-medicinskij žurnal. 2018;339(6):23
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Celiac axis compression syndrome: terminology, diagnosis and treatment

Kokhan E.P., Belyakin S.A., Patsenko M.B., Obraztsov A.V., Mironenko D.A.


The article presents the results of examination of 86 patients with the syndrome of compression of the celiac trunk with hemodynamically significant compression of the vessel, confirmed by instrumental methods of investigation - radiopaque aortography, computed tomographic angiography and color duplex scanning. Surgical methods of treatment (47 patients) included conditionally reconstructive operations (45), reconstructive (1), laparoscopic decompression (1). The nearest results are regarded as positive (good and satisfactory) in 78.7% of those operated. In the nearest postoperative period, complications arose in 10 (21.3%) patients, including reactive pancreatitis, pulmonary embolism, partial divergence of aponeurosis sutures, acute cerebrovascular accident, post-vaginal complications (gastrostasis), erosive hemorrhagic gastritis. Postoperative mortality was 2.1%. In a remote period of 38 patients, good results were achieved in 19 (50%), satisfactory in 15 (39.5%), 4 (10.5%) patients had frequent exacerbations of chronic cystic pancreatitis, acute pancreatitis, Mallory- Weiss, frequent exacerbations of peptic ulcer with the formation of stenosis of the bulb of the duodenum.
Voenno-medicinskij žurnal. 2018;339(6):24-29
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Pleural effusion as an interdisciplinary problem: the experience of providing specialized medical care in a multidisciplinary hospital.

Fokin Y.N., Shklovskii B.L., Tatarin V.S., Badurov B.S., Egorov V.V., Baksheev V.I.


The features of the clinic, diagnosis and treatment of pleural effusions are given. It is emphasized that the diagnosis of pleural effusions is an interdisciplinary problem, in the decision of which doctors of various specialties take part. Verification of pleural effusions can significantly improve modern methods. However, according to the authors of the article, in 9% of cases, it is not possible to reveal the etiology of pleural effusions. The scheme of the integration system for the organization of specialized medical care in a multidisciplinary hospital for patients with pleural effusions has been introduced, the introduction of which has made it possible to increase the effectiveness and quality of treatment of this pathology.
Voenno-medicinskij žurnal. 2018;339(6):29-37
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Experience in the performance of extraperitoneoscopic intrasfascial nerve-sparing radical prostatectomy with conservation of pubovesical complex.

Esipov A.V., Parshin V.V., Gvasaliya B.R., Stegantsev D.I., Esipov A.S., Kochetov A.D.


The efficacy of surgical treatment of 10 patients with a diagnosis of prostate cancer was assessed, which transferred extraperitoneoscopic intrasfacial nerve-sparing radical prostatectomy while preserving the pubovesical complex. Criteria for the effectiveness of this method of surgical treatment were the preservation of erectile function and the absence of incontinence in the early and late postoperative period. As a result of treatment, urine retention was noted in all patients in the postoperative period; in 3-4 months there was a restoration of erectile function without additional stimulation with inhibitors of phosphodiesterase type 5. This technique of prostatectomy involves a detailed understanding of the surgical operative anatomy of the prostate by the surgeon and strict adherence to the basic surgical principles of nerve-sparing in order to significantly improve the quality of life of patients.
Voenno-medicinskij žurnal. 2018;339(6):37-40
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Aneurysmal transformation of the xenoprosthesis in the infrainguinal position.

Pinchuk O.V., Kokhan E.P., Obraztsov A.V., Yamenskov V.V., Kryzhov S.N., Minin K.Y.


Literature data are given on the frequency and possible causes of aneurysmal transformation of the biological prosthesis in the femoral-popliteal-tibial position. Generalized his own experience of 191 infrainguinal arterial reconstruction with the use of xenoprostheses. Significant degenerative changes of the graft in the period from 2 to 10 years were noted in 6.8% of all implantations. Features of the functioning of the biological prosthesis in the arterial position in the remote period are considered.
Voenno-medicinskij žurnal. 2018;339(6):41-44
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Improvment of aortic valve replacement results in elderly patients by using an ON-X implant

Esion G.A., Lishchuk A.N., Koltunov A.N., Karpenko I.G., Li G.A G.A.


The article deals with the acute issues of aortic heart valve replacement in elderly patients (n=487, age - 58-91 year, average age - 69.5±21.5 years). The implantation of the artificial aortic valve for its defect is performed in all patients. The majority of those operated had other diseases of the cardiovascular system, most often the defect of the mitral valve, aortic stenosis, arterial hypertension. The technique of implantation, the results achieved during treatment are described. The five-year survival rate of patients was 98.7%. It was not achieved only in patients whose age at the time of the operation was more than 90 years. The lethal outcome was due to other causes and was not related to the implant operation or the consequences of its implantation. Quality of life of patients after the operation did not deteriorate. The objective mechanical reliability of the implant is underlined.
Voenno-medicinskij žurnal. 2018;339(6):45-48
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Tactics of management of diarrhea of noninfectious genesis in а hospital.

Pavlov A.I., Fadina Z.V.


The efficiency and expediency of enterosorbent enterosgel application in the treatment of non-infectious diseases with diarrhea was assessed. We examined 169 patients with a clinical picture of diarrhea of varying severity. Of these, 62 patients underwent complex pathogenetic and symptomatic therapy, in which enterosgel was administered. The study showed that the inclusion of enterosorbents in the complex therapy of non-infectious diarrhea, regardless of its genesis, allows to shorten the treatment time and helps to accelerate the normalization of the stool. The maximum effect was obtained using enterosgel for the treatment of antibiotic-associated diarrhea and irritable bowel syndrome with diarrhea. The results of enterosorbent enterosgel application in the treatment of diarrhea of non-infectious genesis of various origin prove the effectiveness of its inclusion in complex therapy of these diseases.
Voenno-medicinskij žurnal. 2018;339(6):49-54
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Diagnostic significance of cone beam computed tomography in assessing the condition of lacrimal passages.

Serik A.N., Svetikova L.A., Nazarova N.A., Neverov M.G.


The aim of the study was to improve the diagnosis of the condition of the tear duct with the help of radial methods and to evaluate the diagnostic significance of cone-beam computed tomography. An analysis of the results of cone-beam computed tomography with contrasting of the tear ducts in 32 patients with suspected stenosis or obstruction was performed. It is established that this method of research allows to accurately visualize the anatomical and topographic features of the lacrimal pathways, to determine the state of the skull bone structures surrounding them, the level and severity of the narrowing and obstruction of the lacrimal ducts, their possible causes - diverticula, neoplasms, concrements. CT scan data allow you to select the most effective method of treatment. The relatively low cost of the study and the low radiation dose of the patient are an important advantage of cone-beam computed tomography in comparison with multispiral computed tomography.
Voenno-medicinskij žurnal. 2018;339(6):54-60
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Voenno-medicinskij žurnal. 2018;339(6):60
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Influence of psychoemotional stress on postural stability on the parameters of the statokinesiogram spectrum and heart rate variability

Zhiltsova I.I., Alzhev N.V., Annenkov O.A., Lapshina T.A.


The informational significance of the indices of computer stabilography for the evaluation of the functional capabilities of the pilot’s body under mental stress and psycho-emotional stress was determined experimentally. Correlation of the parameters of the spectrum of the stabilogram with the data of the heart rate variability, which characterize the activity of the autonomic nervous system after the mental load, is revealed. Changes in the parameters of the spectrum of the stabilogram were in the low-frequency zone both in the sagittal and frontal planes in the group with a deterioration in the quality of the equilibrium function. In the group with deterioration of postural stability after mental load, there is a marked increase in the functioning level of the sympathetic part of the autonomic nervous system, which is confirmed by the increase in heart rate variability. In the group of subjects with improvement of the postural function, the influence of the sympathetic part of the autonomic nervous system on the total power of the spectrum of heart rate variability was reduced. The data obtained are applicable for assessing the tolerability of mental loads in the survey of flight personnel and other persons whose professional activity is related to the impact on the body of extreme factors and adverse changes in its functional state.
Voenno-medicinskij žurnal. 2018;339(6):61-69
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Voenno-medicinskij žurnal. 2018;339(6):69
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Medical Service of the Japan Self-Defense Forces.

Aleinikov S.I., Golota A.S., Krassii A.B., Parfenov V.D., Soldatov E.A., Soldatov K.E., Shalakhin R.A.


The article is a brief description of the current state of the Japan Self-Defense Forces medical service and is based on the study of open access foreign sources. At the beginning, the general information about Japan, its Self-Defense Forces, and their medical service is presented. Then the medical service particular features are described with more detail, namely, the organization of the inpatient and outpatient treatment, medical supply, scientific research, combat medicine, medical staff education and training.
Voenno-medicinskij žurnal. 2018;339(6):70-73
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About the difficulties of diagnosing bleeding from the small intestine.

Dolgikh R.N., Chalyi S.N., Parkhomenko S.A., Zavalii I.P., Timonina L.V.


The difficulties of diagnostics of small intestine diseases are considered, the clinical manifestation of which is often the so-called bleeding from an unidentified source. The analysis of clinical cases in the conditions of the department of emergency surgery of a military hospital is made and the main directions for solving the problem are formulated.
Voenno-medicinskij žurnal. 2018;339(6):75-76
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Result of endovascular myocardial revascularization in case of chronic heart failure with a low fraction of left ventricular ejection

Dolgushin O.A., Ivanov A.V., Shames A.B., Girel O.I., Prokhorchik A.A.


The article presents data of a modern approach to the treatment of heart failure with a low ejection fraction. A case of a positive result of multi-stage endovascular myocardial revascularization in a patient with refractory to conservative treatment of heart failure due to ischemic cardiomyopathy and valvular heart disease with a high risk of death for coronary bypass surgery and surgical correction of valvular heart disease is described. In order to reduce mortality and improve the quality of life of comorbid patients with ischemic cardiomyopathy and severe CHF, endovascular myocardial revascularization can be considered an alternative to coronary bypass surgery.
Voenno-medicinskij žurnal. 2018;339(6):76-78
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Syndrome of enteric insufficiency in acute surgical pathology.

Starokon P.M., Dolgikh R.N., Galik N.I.


The complex of medical measures effective for manifestations in patients with enteric insufficiency syndrome was developed for the conditions of a general surgical hospital. 96 patients with acute intestinal obstruction were observed and treated. The curative program of the postoperative period included the draining of the small intestine, enterotrope therapy, the introduction of infusion antihypoxants. The treatment carried out made it possible to significantly improve the manifestations of enteric insufficiency syndrome, in a shorter time to restore the functional consistency of the small intestine.
Voenno-medicinskij žurnal. 2018;339(6):78-81
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Biological therapy as a perspective treatment of severe forms of psoriasis

Tarasenko G.N., Patsenko M.B., Patronov I.V., Kuzmina Y.V.


The experience of using biological preparations in the skin compartment of the military medical organization is presented to patients with severe forms of psoriasis and psoriatic arthritis. The emergence of new drugs for the biologic therapy of psoriasis, such as Cointix (secaquinumab), Otisla (Aprilmilast), with a different mechanism of action on the key links of immunopathogenesis opens a new page in the treatment of severe forms of this disease.
Voenno-medicinskij žurnal. 2018;339(6):81-82
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Experience of antiepidemic support of the Belarusian offensive operation «Bagration»

Krainii V.A., Krainyaya E.V.


Experience of antiepidemic support of the Belarusian offensive operation «Bagration». A comprehensive assessment of the sanitary and epidemiological situation in the temporarily occupied territory of the Byelorussian SSR in 1944 on the eve and during the Belarusian Offensive Operation «Bagration» was made. The peculiarities of the anti-epidemic protection system are discussed, which allowed minimizing losses in the Red Army troops and among the population from infectious diseases, and in the shortest time to carry out measures to prevent the mass spread and elimination of epidemic-dangerous diseases. The accumulated experience was used during the fighting in Afghanistan.
Voenno-medicinskij žurnal. 2018;339(6):83-87
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Voenno-medicinskij žurnal. 2018;339(6):87
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Trishkin D.V.
Voenno-medicinskij žurnal. 2018;339(6):88
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Voenno-medicinskij žurnal. 2018;339(6):89
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Shamrey V.K., Chudinovskikh A.G.
Voenno-medicinskij žurnal. 2018;339(6):89-90
pages 89-90 views

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Voenno-medicinskij žurnal. 2018;339(6):90-91
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Extraordinary conference of the Association of Veterans of the Military Medical Service.

Sobolenko V.K., Galin L.L.


The information on the extraordinary reporting and election conference of the interregional public organization «Association of Veterans of the Military Medical Service», held on 1.02.2018 in Moscow, is presented. The conference was attended by members of the council of the association, delegates of regional associations, as well as veterans - representatives of military medical organizations in Moscow and the Moscow region (more than 160 people). It was decided to conduct organizational work to create new regional branches of the association in military districts and fleets, to intensify mentoring over young military medical specialists, patriotic education of the younger generation, and social protection of veterans. After the election of the new board of the association, Major-General of the Medical Service I.G.Kornyushko was elected its chairman.
Voenno-medicinskij žurnal. 2018;339(6):92-96
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