Vol 339, No 7 (2018)


Influence of the Arctic factor on artetial hypertension and atherosclerosis in military troops

Fisun A.Y., Gordienko A.V., Serdyukov D.Y., Kabisova V.I., Grashin R.A., Grigorev S.G.


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.
Voenno-medicinskij žurnal. 2018;339(7):4-9
pages 4-9 views

Quality management of nursing activity in military medical organizations of the Ministry of Defense

Sviridova T.B., Kostyuchenko O.M., Lim V.S., Khan N.V.


Мanagement of the quality of nursing care is an actual and significant problem. The development of the health care system requires attention to the use of nursing personnel, increasing their knowledge and skills in caring for patients, implementing simple medical services, working with patients and their relatives, providing competent first aid, which necessitates an accreditation procedure instead of the usual certification of specialists, continuous the formation of medical specialists with secondary vocational education. In 2017, on the basis of Branch # 1 of the GVCG them. NN Burdenko conducted an event to prepare for the upcoming procedure for the accreditation of nursing staff, which allowed to identify typical errors and shortcomings: the contestants do not have sufficiently high communicative abilities in communicating with patients; Psychological preparation of the patient is not carried out and the progress of manipulation is not announced; mistakes are made in demonstrating the technique of performing a simple medical service.
Voenno-medicinskij žurnal. 2018;339(7):9-14
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Voenno-medicinskij žurnal. 2018;339(7):14
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Development of an experimental model of severe craniocerebral trauma

Badalov V.I., Shevelev P.Y., Reva V.A., Semenov E.A., Adzhieva Z.N., Mikhailovskaya E.M., Bagnenko S.S., Zheleznyak I.S., Denisov A.V., Arutyunyan A.A., Spitsyn M.I.


A new experimental model of a severe craniocerebral injury, which is applied by a shot from non-lethal firearms, is presented. To diagnose damage to brain structures and disorders of liquorodynamics, intracranial pressure was monitored, computer and magnetic resonance imaging, and postmortem morphological evaluation were performed. A shot in the head of a sedated animal covered with Kevlar from a distance of 1 m (bullet energy of 83 J) led to a rapid significant rise in intracranial pressure, followed by a decrease to baseline values. There were no lethal outcomes as a result of the shot. According to computer and magnetic resonance imaging, signs of brain contusion have been revealed without a significant compressing substrate capable of causing a sharp increase in intracranial pressure. A macroscopic examination revealed subarachnoid hemorrhage, signs of a brain contusion without the formation of intracranial hematomas, which corresponded to a severe craniocerebral trauma. The totality of the obtained data testifies to the reproducibility of non-lethal severe craniocerebral trauma, which can be used for further research in the field of neurotraumatology.
Voenno-medicinskij žurnal. 2018;339(7):15-21
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Optimization of therapeutic and diagnostic approaches with angina pectoris and non-obstructive lesions of the coronary arteries

Kryukov E.V., Potekhin N.P., Fursov A.N., Chernov S.A., Gaidukov A.V., Balanyuk E.A., Pestovskaya O.R., Zakharova E.G.


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.
Voenno-medicinskij žurnal. 2018;339(7):21-27
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Pulmonary contusion: diagnostic problems and treatment tactics

Denisov A.V., Suprun A.Y., Gavrilin S.V., Meshakov D.P., Nedomolkin S.V., Markevich V.Y., Suvorov V.V., Zhirnova N.A., Dmitrieva E.V., Demchenko K.N.


Timely diagnosis of pulmanory contusion with chest injuries is an urgent task, which is due to the high probability of its complications. In the general structure of severe combined injuries, the incidence of pulmanory contusions is 30.1%. Pulmonary contusion significantly increases the risk of developing pneumonia and can be a direct cause of the development of acute respiratory distress syndrome. In case of development of complications with extensive pulmonary contusion, the lethality reaches 90%. Among the causes of deaths is severe sepsis, in its absence - brain damage and severe massive blood loss of extremely severe severity. The article considers modern diagnostic methods and tactics of treatment of pulmonary contusion depending on the area of pulmonary parenchyma lesions, as well as the effect of pulmonary contusion on the course of traumatic illness.
Voenno-medicinskij žurnal. 2018;339(7):28-34
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Dental health in discharged military personnel of the Armed Forces

Nikitenko V.V., Ivanov A.S., Lyskov N.V., Mormul V.V., Spesivets A.F., Polevaya L.P.


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.
Voenno-medicinskij žurnal. 2018;339(7):35-38
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Voenno-medicinskij žurnal. 2018;339(7):38
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Application of forces and facilities of military sanitary-and-prophylactic institutions in the disaster recovery: еpidemiological and organizational aspects

Lantsov E.V., Kuzin A.A., Kobylkin D.V., Azarov I.I., Kucherov A.S., Aminev R.M.


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.
Voenno-medicinskij žurnal. 2018;339(7):39-46
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Independent work experience of a mobile sanitary-epidemiological group under extreme climatic conditions

Volkov I.I., Simakov V.V., Reinyuk V.L., Soldatov E.A.


The main results of the work of the mobile sanitary-epidemiological group on the territory of the remote region of the field deployment of troops in extreme climatic conditions are given. The possibilities and methods used for conducting laboratory studies of water, soil, air and other environmental objects are described with the possible presence of a source of infection by biological and chemical agents. The minimum level of the necessary equipment for the work of the group in medical areas that are less well researched is shown. Sanitary-epidemiological condition of the field camp is assessed as safe. Natural foci of zooanthroponoses, as well as signs of production and storage of chemical and biological weapons in the surveyed territory, were not identified.
Voenno-medicinskij žurnal. 2018;339(7):47-52
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Opportunities of the center for quality control of medicinal products in search of promising sources of medicinal plant raw materials

Levchenko V.N., Zveryachenko A.S., Paskar G.V., Stepnova I.V.


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.
Voenno-medicinskij žurnal. 2018;339(7):53-59
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Voenno-medicinskij žurnal. 2018;339(7):59
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Anthropomorphic manikins for studying the mechanism of the mine-explosive trauma of the lower extremities and predicting the severity of injuries

Anisin A.V., Logatkin S.M., Denisov A.V.


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.
Voenno-medicinskij žurnal. 2018;339(7):60-64
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Experience in the organization and functioning of the School of Health for patients with circulatory diseases in the military sanatorium

Avershin V.A., Bitsadze A.N., Kuznetsov V.M., Radaev A.G.


The analysis of the experience of the organization and functioning of the School of Health for patients with diseases of the circulatory system in the branches of the Sochinsky Sanatorium and Resort Complex is presented. The implementation of this educational project showed the patients’ interest in this new form of medical and preventive work for the sanatoriums: 480 lessons (lectures, seminars, practical exercises, family and individual conversations) that were attended by more than 3 thousand people per year. The most important indicator of the effectiveness of the School of Health can be considered an increase in the number of patients with diseases of the circulatory system discharged with improvement - 98.9% of patients with coronary heart disease, hypertension, cerebrovascular diseases, who were on sanatorium treatment and medical rehabilitation.
Voenno-medicinskij žurnal. 2018;339(7):66-68
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To the problem of optimizing the use of anticoagulant therapy in outpatient clinics

Popov A.P., Didenko O.I., Gvozdikov A.V., Solovkina L.V., Khachaturyan L.E., Profatilova G.V.


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.
Voenno-medicinskij žurnal. 2018;339(7):68-69
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Severe course of influenza A / H1N1 at a young age: a case from practice

Orlova N.V., Zaitsev A.A., Stazhinskii A.N., Balashov E.V., Kozovoi M.Y., Kacher V.V.


A clinical case of severe A / H1N1 influenza in a young woman with the development of acute respiratory distress syndrome, subtotal viral-bacterial pneumonia is described. A special feature of the example is the clinical course of severe fatal influenza infection with the development of massive thrombosis of the lower lobe branch of the left pulmonary artery. This was facilitated by the lack of flu vaccine and late treatment of the patient, inadequate readiness of specialists in terms of diagnosing severe complications of influenza infection, later on the initiation of etiotropic antiviral therapy, which was prescribed only during admission to hospital, delaying the patient’s transfer to mechanical ventilation.
Voenno-medicinskij žurnal. 2018;339(7):70-72
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Case of an injured internal hernia in the late postoperative period after subtotal resection of the stomach

Sidorenko M.G., Kakhktsyan K.S.


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.
Voenno-medicinskij žurnal. 2018;339(7):72-73
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Predictors of the effectiveness of osteopathic techniques in the complex treatment of chronic acalculous cholecystitis in discharged officers

Matvienko V.V., Pankov O.A., Frolkov V.K., Zhernov V.A., Zubarkina M.M.


The effectiveness of osteopathic techniques in complex treatment of patients with chronic acalculous cholecystitis was analyzed based on the results of direct and remote observations. The study was conducted on two groups of reserve soldiers for 54 people in each. The experimental group received osteopathic treatment instead of a massage on the background of standard therapy. Biochemical indices of blood and bile were compared, as well as pathobiomechanical disorders of organs of the subdiaphragmatic space. Estimation of predictors for the effectiveness of osteopathic treatment was carried out using dispersion, correlation and regression analyzes on the Statistica v 7.0 software package (Statsoft).
Voenno-medicinskij žurnal. 2018;339(7):73-75
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System of examination and treatment in health resorts of children with diseases of the musculoskeletal system

Nenko A.M., Vlasenko S.V.


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.
Voenno-medicinskij žurnal. 2018;339(7):76-78
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Prominent figure in military medicine (to the 100th anniversary N.G.Ivanov)

Fisun A.Y., Shelepov A.M., Kulnev S.V.


The article is dedicated to the 100th anniversary of the birth of a prominent figure in military medicine, colonel-general of the medical service Nikolai Gennadievich Ivanov (1918-1994). Under his leadership, there have been significant changes in the structure of the Military Medical Academy: departments of military toxicology and medical protection, automation of management and military medical statistics, and a number of research laboratories have been established. Reconstruction and overhaul of many departments and clinics, built hostels for cadets and listeners, built a unique educational and laboratory building. Ivanov N.G. made a great contribution to the scientific development of a number of problems of military medicine (forecasting the size and structure of the sanitary losses of troops from modern weapons, organizing medical support for associations in operations, automating the management of medical services, etc.).
Voenno-medicinskij žurnal. 2018;339(7):79-81
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The Main Military Sanitary Department and the People’s Commissariat of Health in 1918-1920

Poddubny M.V.


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.
Voenno-medicinskij žurnal. 2018;339(7):81-87
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The Stavropol military hospital celebrates the 75th anniversary

Papko S.V., Kokoev V.G., Gadzhiev A.A., Polezhankin E.V.


The publication presents the history of the Stavropol military hospital since 1943. During its 75-year work period, the Stavropol Military Hospital (now branch No. 1 of the 1602nd Military Clinical Hospital of the Russian Ministry of Defense) made a great contribution to the medical support of the troops of the Southern Military District, one of the best hospitals - branches, is a multi-disciplinary medical and preventive institution, successfully fulfilling the tasks assigned to it to preserve and strengthen the health of servicemen of the Russian army, the military x pensioners and families in the Stavropol garrison.
Voenno-medicinskij žurnal. 2018;339(7):88-89
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Voenno-medicinskij žurnal. 2018;339(7):91-93
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Meeting of the main traumatologists of military districts and fleets

Kotiv B.N., Khominets V.V., Kudyashev A.L.


A short report on the meeting (gathering) of the main traumatologists of military districts and fleets of the Armed Forces of the Russian Federation, which was held in February 2018 in St. Petersburg, is presented. The purpose of the event was to discuss the problematic issues of organizing trauma and orthopedic assistance in the Armed Forces of the Russian Federation, the issues of medical supply in the light of the main provisions of the legislation in the field of health care of citizens of the Russian Federation, the continuity of assistance in the field of traumatology and orthopedics, medical aid in the field of «traumatology and orthopedics». Participants of the meeting attended the plenary and most thematic sectional sessions, including «Combat damage to the limbs», «Combat head, chest, pelvis, spine and abdominal injuries», «Polytrauma», «Rehabilitation issues», etc.
Voenno-medicinskij žurnal. 2018;339(7):94-96
pages 94-96 views

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