Vol 339, No 9 (2018)


Implementation of the project «Development of military medicine. Strengthening the health of servicemen» of the program «Effective Army» in the Armed Forces

Kuvshinov K.E., Pastukhov A.G., Tatyanenko A.S., Mindlina A.S., Zemlyakov S.V.


In accordance with the decision of the Minister of Defense of the Russian Federation, General of the Army S.K.Shoigu, the project «Development of military medicine. Strengthening the health of servicemen» of the «Effective Army» program aimed at increasing the effectiveness of spending budget funds for the medical provision of the Armed Forces, the accessibility and quality of medical care provided to servicemen and citizens discharged from military service. For the period of project implementation in 2015-2017 the number of servicemen and dismissed from military service increased by 9% annually, and free medical care was provided annually, and medical and psychological rehabilitation was provided 241.3%, medical facilities provided with modern medical equipment grew by 4%, and annual budgetary savings were increased By 2017, it exceeded 1 billion 375 million rubles. The implementation of the project activities will be continued in 2018-2020. According to preliminary estimates, after its implementation, the annual economic effect can reach up to 4.6 billion rubles.
Voenno-medicinskij žurnal. 2018;339(9):4-10
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Ethics and law in the doctor-patient relationship in military medicine

Bychkova O.I., Donika A.D., Sedova N.N.


The article describes the problem of ethical regulation of internal relationships of the social institution of military medicine, the reform of which is connected with the issues of the Russia’s national security. The results of a study of the relationship between physicians and patients of a number of military hospitals are presented in order to determine the legal norms necessary to optimize these relations and, consequently, to improve the quality of medical care for servicemen. The study used methods of general sociology and sociology of medicine. A content analysis of legislative acts regulating relations in the field of military medicine was conducted. It is established that the ethical patterns of military medicine are directly related to the global process of modernization of the Armed Forces and the improvement of the regulatory regulation of the military medical service. The ethics of the relationship between a military doctor and a patient soldier has a direct impact on the process of medical care, which determines the relevance of integrating bioethical issues into the system of training medical specialists.
Voenno-medicinskij žurnal. 2018;339(9):11-15
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Effect of cytoarchitectonics of the spleen in old age on its blood filling and localization of gaps (experimental study)

Pinchuk P.V., Leonov S.V., Levandrovskaya I.A.


The establishment of the spleen damage mechanism is one of the main issues in the manufacture of forensic medical examinations of people with trauma of this organ. Despite a large number of scientific works devoted to the establishment of the mechanism of spleen injury, there is no data on the effect of its internal structure (cytoarchitectonics) on the formation and distribution of stresses in the organ. The results of experimental macroscopic studies of the internal structure of the spleen, as well as changes in the size characteristics of the organ in both sexes, mainly of senile age, are presented. The age-related changes in deformity and strength characteristics of the spleen have been determined significantly, the most dangerous areas on the body of people of senile age have been identified for the formation of organ damage, which must be taken into account when establishing the organ trauma mechanism both in the clinical diagnosis of spleen injuries and forensic medical examinations.
Voenno-medicinskij žurnal. 2018;339(9):16-20
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Voenno-medicinskij žurnal. 2018;339(9):20
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Heart contusion in case of gunshot wounds

Samokhvalov I.M., Gavrilin S.V., Kuzmin A.Y., Meshakov D.P., Nedomolkin S.V., Denisov A.V., Suprun T.Y., Zhirnova N.A.


Contusion of the heart in severe combined wounds and injuries - an urgent problem of surgery of injuries, anesthesiology and reanimation. Based on the database of the clinic of military field surgery of the Military Medical Academy named by S.M.Kirov on gunshot wounds received in local armed conflicts, shows the incidence of a heart injury in the overall structure of gunshot wounds, the frequency of complications and lethality. The analysis of the clinical course of the disease in wounded patients with a heart attack against a background of mine-explosive wounds of the chest, shrapnel wounds of the chest, with bullet wounds of the chest.
Voenno-medicinskij žurnal. 2018;339(9):21-28
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Surgical treatment of severe aortic stenosis in elderly and senile patients with high operational risk

Kranin D.L., Gaidukov A.V., Fedorov A.Y., Nazarov D.A., Varochkin K.A.


The global trend of population aging causes an increase in the average age of patients with aortic stenosis, and consequently the severity of the concomitant pathology also increases. In view of the high surgical risk, many patients with severe aortic stenosis are denied surgical treatment. The aim of the study was to compare the results of aortic valve replacement in conditions of artificial circulation (n=20) and transcatheter aortic valve implantation (n=21) in elderly and senile patients with high operational risk. It has been established that an effective method of treating this pathology is prosthetic aortic valve, and the only safe method is endovascular, which is combined in the procedure of transcatheter aortic valve replacement. The advantages of transcatheter implantation of the aortic valve are the possibility of eliminating the risk of anesthetic care by performing an operation under local anesthesia, a significant reduction in pain compared to open surgery, a significant reduction in the length of the patient’s stay in the hospital.
Voenno-medicinskij žurnal. 2018;339(9):29-35
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Clinical and biorhythmological aspects of rehabilitation of patients with myocardial infarction: diagnosis, treatment, adaptation

Kosov V.A., Ermolin S.N., Khudziev B.G., Trebina N.P., Grubalskaya G.V.


During the three 11-year cycles of the Schwab-Wolf (1985-1996-2007-2017), 2528 patients with myocardial infarction - men aged 28-60 years, at different times after the infarction (16 days - 5 years) were examined. The external and internal causes of desynchronosis, which affect the incidence of myocardial infarction and its course, have been studied. The effectiveness of their correction in the process of rehabilitation in a sanatorium with the use of natural, preformed, pharmacological agents and their combinations has been estimated. The developed diagnostic and therapeutic algorithms allowed to increase the detection of early forms of desynchronosis in patients with myocardial infarction not only by clinical indicators, but also by functional, metabolic and psychological. A differentiated qualitative and quantitative assessment of the degree of severity of adaptation was carried out, which allowed for long-term monitoring of the course of the disease in the early and distant post-infarction periods, and monitoring of the implementation of therapeutic and preventive measures. On the basis of statistical data and multi-criteria analysis, a model of the algorithm for predicting the effectiveness of rehabilitation of patients with myocardial infarction from the position of chronomedicine was developed.
Voenno-medicinskij žurnal. 2018;339(9):36-43
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Comparative evaluation of methods of dental rehabilitation with consequences of gunshot wounds in the maxillofacial area

Iordanishvili A.K., Kuvshinova A.K., Muzykin M.I., Serikov A.A.


In the process of research of the psycho-sensory-anatomo-functional disadaptation syndrome, the peculiarities of psychological disadaptation of adult patients with the consequences of gunshot wounds of the maxillofacial area and their satisfaction with the results of dental rehabilitation were studied. It is shown that the use of nonremovable and conditionally removable dental prostheses on dental and zygomatic implants for rehabilitation has made it possible to achieve full satisfaction with the results of dental orthopedic treatment in 81.8% of patients, which indicates the need for their widespread use on artificial supports for dental rehabilitation of those injured in maxillary face region.
Voenno-medicinskij žurnal. 2018;339(9):43-47
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Streptococcal infection in military collectives: features of epidemiology, rapid diagnosis and prevention

Nikolaev R.V., Marin G.G., Butakov S.S., Kuzin A.A., Zharkov D.A., Volynkov I.O., Sergeeva N.V.


The leading role of streptococci in the etiology of upper respiratory tract and pneumonia in servicemen, skin diseases and subcutaneous tissue determines the importance of timely diagnosis of streptococcosis and the need to carry out effective and common for their various nosological forms of anti-epidemic and therapeutic-prophylactic measures. The article presents the results of clinical testing of the rapid diagnostic test system «Streptatest». The carrier of the b-hemolytic streptococcus of the A group of 200 military personnel under the contract, who had consulted about acute tonsillitis, was examined. Of these, the number of patients with a positive test was 31 (15.5%), with a negative - 169 (84.5%). Prior to the application of the test system, antibiotic therapy was prescribed in 80-90% of cases, after the beginning of its use of antibiotics was reduced to 16%. Determination of the prevalence of b-hemolytic group A streptococcus in military collectives and differential rapid diagnosis of streptococcal infections allow one to temporarily make the necessary medical appointments, reduce the risk of complications and the severity of the course of the disease, and reduce economic costs for treatment.
Voenno-medicinskij žurnal. 2018;339(9):48-56
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Сell engineering in restoration of insulin production in type 1 diabetes mellitus patients

Nagibovich O.A., Golota A.S., Krassii A.B.


The article is dedicated to the current state and prospects of cell engineering in the treatment of type 1 diabetes mellitus by restoration of pancreatic insulin production. The material is based on analysis of clinical trials on this topic submitted to international registry СlinicalTrials.gov from 01 January 2016 to 18 March 2018. It is founded that for the mentioned period in the discussed problem the certain progress has beed made. Although it should be recognized that the analyzed studies belong to the stage of initial clinical experiment and because of that they cannot so far be consider as a subject for translation into any brought clinical practice. At the same time there is a reason to expect the serious advances on the topic in the coming years. This is indicated by the presence at the registry СlinicalTrials.gov as of 18 March 2018 at once ten clinical trials on the topic in active state recruiting participants or preparing for recruitment.
Voenno-medicinskij žurnal. 2018;339(9):57-61
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Telemedicine at battlefield: past, present and future. Editorial review

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Voenno-medicinskij žurnal. 2018;339(9):62
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Modern technologies of visual anti-alcohol propaganda

Gaivoronskii I.V., Nichiporuk G.I., Emel’yanov V.N., Tumilovich O.A., Chetyrin V.V., Kozhokaru D.V.


Despite a wide range of existing forms and methods of fighting alcohol consumption, their effectiveness remains low. This is due to the abundance of various instructional information. Methods for preventing alcohol consumption and popularizing a healthy image, developed by the Department of Normal Anatomy of the Military Medical Academy, are based on demonstrating natural anatomical drugs in norm and with pronounced pathological changes in alcoholism. This technology has shown its high effectiveness in combating the addiction and contributes to the formation of a conscious need to maintain a healthy lifestyle.
Voenno-medicinskij žurnal. 2018;339(9):63-65
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Effectiveness of immunomodulating therapy in the complex treatment of angina in the military

Orlov F.A., Pantyukhova T.N., Orlova E.F.


The article deals with the incidence and prevalence of angina in organized military collectives. The results of the observational (not intervention) study of the effectiveness of the drug aminodihydrophthalazinedione sodium in the complex treatment of uncomplicated sore throat in conscripts. It was shown that the inclusion of sodium aminodihydrophthalazinedione in the complex treatment of angina contributes to earlier relief of intoxication and catarrhal syndromes, normalization of hematological parameters, and a decrease in the duration of the disease.
Voenno-medicinskij žurnal. 2018;339(9):65-67
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Clinical example of the correlation (association) between heart rhythm disturbances and the obstructive sleep apnea syndrome

Steklov V.I., Kulenko P.I., Ivanov V.Y., Zaitsev A.A., Mostovoi L.V., Voitenko A.G.


Clinical observation of a patient with transient AV block of the 2nd degree of Mobitz 2, a transient CA-block of the 2nd degree against the background of respiratory sleep disorders is given. The high efficiency of CPAP therapy in the treatment of this pathology of rhythm disturbances and conduction of the heart is shown. The criteria for selecting patients with the night bradyarrhythmia for performing cardiorespiratory monitoring are formulated, and proposals for dispensary observation of patients receiving CIPAP therapy are formulated.
Voenno-medicinskij žurnal. 2018;339(9):67-70
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Modern Views on the Management of Patient Safety

Voskanyan Y.E., Aveticyan A.Y.


The paper sets out the key principles of safety management of medical care, that provide for the construction of a proactive culture of risk management of the injury; the creation of an effective accountability mechanism and algorithm of investigation of incidents, implementation of a multilevel model of prevention of the transformation of the latent threat into an adverse event. These principles are based on the understanding of the main mechanism of development of complications of medical interventions - the transformation of latent threat into an adverse event through a dangerous situation, a dangerous process and a dangerous event.
Voenno-medicinskij žurnal. 2018;339(9):70-72
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Prophylaxis of prosthetic stomatitis

Shashmurina V.R., Fedoseev A.V., Kiryushenkova S.V., Nikolayev A.I., Rainauli L.V., Lobovkina L.A.


The effectiveness of the application of chemical and physicochemical methods of disinfection of acrylic dentures is estimated. It is established that 50.06% of people using removable dentures on the mucous membrane of the mouth find Candida fungi. Of the material taken from the basis of prostheses, fungi C. albicans (54.57±0.78%) are excreted at a high frequency. As a result of microbiological studies, it has been proven that the use of 0.25 and 1% solutions of the Optimum preparation in combination with ultrasound and without it for disinfection of removable prostheses has a pronounced anticandion effect. The results of the study make it possible to recommend these methods for use in dental clinics and dental laboratories.
Voenno-medicinskij žurnal. 2018;339(9):72-73
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To the history of the 454th military hospital of the Ministry of Defense of Russia

Kalmykov A.A., Eropolov E.V., Plotnikov A.V., Golovko G.R., Plotnikova K.M.


The history of the 454th military hospital, which dates back to October 10, 1956, is presented. Over the years, the organizational and staff structure and name of the hospital have changed many times, but the essence of the work has not changed: the provision of qualified and specialized medical assistance to servicemen, reserve officers, members of their families, war participants, civilian personnel of the Ministry of Defense.
Voenno-medicinskij žurnal. 2018;339(9):74-77
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Prerequisites and trends of military medical education formation in Russia in the 19th century

Karpenko I.V., Rusanov S.N., Tretyakov N.V., Afanasev O.N., Lemeshchenko E.Y., Volovchenko G.N.


The article considers historical prerequisites and main trends in the development of military medical education in Russia in the XIX century. It is noted that this problem has practically not been reflected in the domestic historical medical literature. Among the main prerequisites for the formation of military medical education are important scientific discoveries in the field of natural science made at the turn of the eighteenth and nineteenth centuries, the development of clinical medicine due to them in this period, the appearance of the first domestic theoretical works devoted to military medicine, the complication of medical support for the army and other.
Voenno-medicinskij žurnal. 2018;339(9):78-82
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Soviet epidemiological and parasitological expeditions to Iran in 1941-1943

Mokrousov V.N., Kravtsov V.Y., Kravtsova L.L.


The article is devoted to the work of the three Soviet epidemiological and parasitological expeditions that carried out in Iran from December 1941 to July 1943 the task of providing anti-epidemic protection to the Red Army troops stationed on the territory of that country after the Soviet-British Operation Consent. The emergence during the operation of a large number of infectious diseases of personnel required urgent anti-epidemic measures. Expeditions under the guidance of Academician E.N.Pavlovsky thoroughly and comprehensively studied each area of the deployment of troops, compiling a detailed report on the diseases characteristic of individual localities. In the studies, a comprehensive approach was used to assess the impact of climatic and geographical factors, water supply characteristics, health status, dominant religious dogmas and customs of the Iranian population on the epidemic processes. Numerous microbiological studies have been performed to identify pathogens of infectious diseases among the population, in the environment. The ways of distribution of cholera and the danger of its introduction into Soviet territories were analyzed in detail. Foci of major transmissive diseases were studied. The work of the expeditions in terms of the volume, the vastness of the problems studied, the depth and practical significance were a great contribution to ensuring the sanitary and epidemiological well-being of the Red Army military contingents deployed in Iran.
Voenno-medicinskij žurnal. 2018;339(9):82-87
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Forensic-medical laboratory of the Ministry of Defence in Chita celebrates the 70th anniversary

Starnovskii A.P., Butin A.P., Reshetnikova S.S., Turanov O.A.


The article presents the history of the development of the forensic-medical laboratory in Chita, which dates back to May 1948. Over the years, the organizational and staff structure and name of the institution have changed many times, but the forensic laboratory has always fulfilled its main mission.
Voenno-medicinskij žurnal. 2018;339(9):88-91
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Voenno-medicinskij žurnal. 2018;339(9):91
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Kaleko S.P.
Voenno-medicinskij žurnal. 2018;339(9):92
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Voenno-medicinskij žurnal. 2018;339(9):92-94
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53rd Congress of the European Association for the Study of the Liver

Zhdanov K.V., Kozlov K.V., Zhabrov S.S., Sukachev V.S.


A short report is presented on the 53rd International Congress of the European Association for the Study of the Liver, held in April 2018 in Paris. Among the participants there were collaborators of the Department of Infectious Diseases of the Military Medical Academy. The congress was the first to present clinical recommendations for the diagnosis and treatment of infection caused by HEV, which is of current importance in the context of medical provision of military contingents performing tasks in countries with hot climates.
Voenno-medicinskij žurnal. 2018;339(9):95-96
pages 95-96 views

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