Vol 339, No 7 (2018)

Specialists of the Hospital Therapy Clinic of the Military Medical Academy conducted in-depth examination of 180 male servicemen, including 106 servicemen of the Arctic group and 74 who served in the temperate climate. All have an objective status, lipid, carbohydrate metabolism, thickness of the intima-media complex. It is established that military service in the climatic and geographical conditions of the Arctic zone is associated with insufficient intake of fresh fruits and vegetables and a higher prevalence of smoking. The prevalence of other predictors of cardiovascular diseases (arterial hypertension, obesity, hypodynamia) in this group of servicemen is less pronounced. The Arctic factor due to its interrelation with metabolic disorders (dyslipidemia, dysglycemia) should be considered as an additional atherogenic influence, which may be subjected to military men - young and middle-aged men.

210 patients with ischemic heart disease and angina were examined. 90 patients (42.9%) had hemodynamically significant stenoses of the coronary arteries (70%) - the first study group. In 120 (57.1%) patients, either hemodynamically insignificant stenoses (<70%) or coronary arteries remained intact (group 2 of the study). Analysis of patients of the 2nd group revealed its heterogeneity: in 72 - stenoses of coronary arteries of the heart did not exceed 70% (1st subgroup), and in 48 - coronary arteries remained intact (microvascular type of angina pectoris, 2nd subgroup). Evaluation of pretest probability of coronary artery lesion in patients with angina pectoris can be refined using a prognostic equation developed on the basis of mathematical modeling, which allows before angiography to assume no changes in the coronary bed with a probability of more than 80%. In patients with atypical angina and a high pretest probability of coronary artery stenosis or with typical angina, but with a low probability of coronary atherosclerosis, it is advisable to supplement the examination with special functional techniques, in particular, a VEM test with an evaluation of the Duke index, stress EchoCG. In a number of cases, direct angiography may be preceded by multispiral computed tomography. In patients with predictable angina associated with intact arteries, it is advisable to carry out a non-invasive assessment of the vasodilatation function of the brachial endothelium, which allows indirect confirmation of the microvascular origin of angina pectoris.

The analysis of outpatient dental charts and questionnaires of servicemen of the reserve of the Armed Forces of the Russian Federation, as well as members of their families (69 men and 18 women) aged 61 to 91 years who are on orthopedic treatment in the dentistry department of the Centralized Dental Clinical Hospital No. 104 of St. Petersburg. The estimation of the stomatological status of the surveyed contingent is made in accordance with its need for demountable and non-pregnant prosthetics, the values of the KPU index and the analysis of the periodontal card. On the basis of a comparison of the data obtained, it follows that servicemen serving under the conditions of level I of dental care had a lower dental status than those serving in II and III levels. The results obtained make it possible to characterize the quality of rendering dental care to servicemen at various levels of dental care.

When eliminating the consequences of emergencies, military personnel may be at risk of contracting infectious diseases. This dictates the need to organize well-founded and rational sanitary and anti-epidemic (preventive) measures in the system of ensuring epidemiological safety of troops in these conditions. The article outlines the features of organizing and carrying out activities aimed at anti-epidemic protection of troops in the emergency zone. Various versions of the use of the forces and means of military sanitary-and-prophylactic organizations for carrying out these measures are proposed. The ways of solving the problems of the technical equipment of the state sanitary epidemiological control centers of the Russian Ministry of Defense have been determined to improve the effectiveness of anti-epidemic support for the troops.

The article is devoted to the history of the development of pharmacognosy and the characteristics of the current state of the study of medicinal plants and the production of medicines from plant raw materials. Herbal preparations have a number of advantages in comparison with chemical synthesized medications. Having sufficient medical efficiency, they are relatively cheap and easy to manufacture. With the appointment of patients with drugs of plant origin successfully combined with other medicines, in particular, in the treatment of diseases complicated by concomitant pathology. Low toxicity and the absence of side effects allow them to be used for a long time for chronic diseases and during rehabilitation. The import substitution program and the interests of the revival of the domestic pharmaceutical industry determine the need for active study and use of domestic medicinal raw materials. The experience of the testing laboratory of the Center for Pharmacy and Medical Technology of the Ministry of Defense of the Russian Federation on the basis of the latest methods of the composition of medicines and the study of medicinal plant raw materials is presented.

The review of the materials of available foreign publications on the topic of mine-blasting injury for the last 5 years is presented. For many years, its mechanism was studied using human corpses and anthropomorphic mannequins of civil and military use. However, comparative studies in recent years have shown that the techniques used to perform the «crash test» do not fully take into account the actual physical processes occurring during the explosion. This caused the need to develop virtual or mathematical models. Ideally, we need a model that most fully and with the greatest possible accuracy reflects the reaction of the human body under a blast. It is not yet possible to create such a model. The main problem is the lack of an adequate database of experimental data necessary for calculating the algorithms on which such a model will operate. Thus, the creation of methods for studying the mine-blast injury of the lower limb is currently at the stage of changing the research paradigm, when traditional approaches are recognized as obsolete, and new ones are yet to be developed.

The experience of anticoagulant therapy in the conditions of a private office of anticoagulant therapy of the consulting and diagnostic center is presented. During the work of this office there were not a single case of cerebral circulation disorder in patients receiving oral anticoagulants. It is shown that the use of new oral anticoagulant drugs has several advantages over the traditional use of warfarin.

The article describes a rare case of an injured postoperative internal hernia that occurred in the late postoperative period in a patient operated on for stomach cancer. Previously performed subtotal resection of the stomach according to Billroth-II in the modification of Ru created the conditions for the formation of internal hernia and its subsequent infringement. In order to prevent internal herniation in these operations, it is initially necessary to perform fixation to the parietal peritoneum of the small intestine loop from her mesentery to gastroeuroanastomosis.

The system of examination and treatment of children with pathology of the musculoskeletal system developed in the sanatorium is presented. The system is based on the study of complaints, anamnesis and symptomatology, the use of clinical, radiologic, ultrasonographic, instrumental-graphic, electrophysiological and laboratory research methods. Its structure includes general and particular (with respect to nosological forms) subsystems. The order and principles of sanatorium-and-surgical treatment at the balneological resort of patients with Calve-Perthes disease are stated.

The chronology of some events related to the first year of existence of the People’s Commissariat of Health of the RSFSR was reconstructed on the basis of archival sources introduced for the first time from the State Archives of the Russian Federation, the process of interaction between the People’s Commissariat of Health and the Main Military-Sanitary Directorate of the Red Army is shown. The position of military medicine in the system of priorities of Soviet power during the Civil War is characterized.