Vol 339, No 10 (2018)


Experience in the deployment infectious militaryfield hospital of the Defense Ministry of the Russian Federation in the Republic of Guinea

Zhdanov K.V., Azarov I.I., Sydorchuk S.N., Zakharenko S.M., Polyakov V.S.


In December 2013, the Republic of Guinea began an outbreak of Ebola virus disease, which later spread to neighboring countries. The outbreak became the largest ever monitoring of the disease. The leadership of Guinea appealed to the international community, including Russia, for help. The President of the Russian Federation Vladimir Putin responded to the request and instructed defense Minister Sergei Shoigu to send to this country as a gift from the Russia infectious disease field hospital. Russia took this step in the framework of international efforts to combat Ebola. Since August 2014, one of the world’s largest manufacturers russian aluminum United Company RUSAL has started to carry out logistical support activities of the special anti-epidemic brigade of the Federal Service for Surveillance in the Sphere of Consumers Rights Protection and Human Welfare and mobile anti-epidemic research laboratory in Guinea. Since November 2014, the company has started implementation of measures for the deployment in Guinea of the infectious disease field hospital for 100 beds. A group of officers of the Main military medical department, the S.M.Kirov Military medical Academy and the Central military district of the Russian Federation provides practical and methodological assistance in the deployment and operation of the infectious disease field hospital transferred to the Guinean side.
Voenno-medicinskij žurnal. 2018;339(10):4-9
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Optimization of the management of the activity of the dental organization based on the methodology of the system approach

Papko S.V., Krainyukov P.E., Avetisyan A.Y.


The developed methodology of criterial evaluation of the quality and efficiency of the work of a medical organization that provides primary medical and sanitary dental care (dental clinic, dental department of a polyclinic, a dental office) is presented. The results allow the health management body, the head of the dental organization to improve the management of the organization based on objectivization of data on its status. In accordance with the selected criteria (54) and the coefficients of their importance established by the expert method (in fractions of a unit - from 0.0106 to 0.0816), a methodology was developed and a formula was proposed for quantitative assessment of the quality of primary dental health care, the severity of the diagnosis and its formulation in accordance with ICD-10, the adequacy of the appointment of diagnostic studies and the appointment of treatment activities, the completeness of their implementation of diagnostic studies, the quality of the Examination of temporary disability and medical clearance-tion documentation. Ways of preventing conflict situations with patients have been determined.
Voenno-medicinskij žurnal. 2018;339(10):10-14
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Blunt head trauma: morphology, modeling and expert evaluation

Pinchuk P.V., Leonov S.V., Vereskunov A.M., Shakiryanova Y.P.


A case from expert practice is shown, demonstrating the difficulty of conducting differential diagnostics between input and output gunshot head injuries when they are formed by a bullet that has passed through a solid barrier (protective helmet). Because of the complex forensic, medical, forensic and forensic investigation of a corpse and a protective helmet worn on the victim’s head at the time of damage, it was possible to reliably establish the nature of gunshot wounds, the direction of the wound channel, the features of their formation and the mechanism of injury.
Voenno-medicinskij žurnal. 2018;339(10):15-19
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Voenno-medicinskij žurnal. 2018;339(10):19
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Current state and improvement of traumatologic and orthopedic aid to the wounded with limb trauma

Shapovalov V.M., Khominets V.V., Brizhan L.K., Davydov D.V., Chirva Y.V., Shchukin A.V., Fedotov A.O.


The study was carried out based on two central military medical organizations of the Ministry of Defense of the Russian Federation: the clinic for military traumatology and orthopedics of the S.M.Kirov Military Medical Academy and the Center for Traumatology and Orthopedics of the N.N.Burdenko Main Military Clinical Hospital. It includes two sets of clinical studies. The first array contains a scientific analysis of the treatment of 148 wounded with gunshot fractures of limb bones in the clinic of military traumatology and orthopedics in the period from 1999 to 2015. The aim of the study was to improve the results of surgical treatment of the wounded in the limb by developing and implementing surgical tactics for the use of sequential osteosynthesis. The second one is an independent analysis of the treatment of 298 wounded limbs who were in the Main Military Clinical Hospital in the period from 1995 to 2017 and reflects modern clinical and organizational perspective directions, which allow to significantly improve the results of treatment of the wounded.
Voenno-medicinskij žurnal. 2018;339(10):20-27
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Method for the prevention of implant-associated inflammation in the area of the spermatic cord

Chernykh V.G., Krainyukov P.E., Bondareva N.V., Efremov K.N.


Implantation of polypropylene mesh causes a pronounced inflammatory reaction in the zone, thus stimulating the formation of connective tissue scar with involvement of the elements of the spermatic cord. The creation of an additional layer above the graft reduces the degree of implant-associated inflammation in the tissues of the spermatic cord. Peritonization of the net is carried out by a non-free graft of the peritoneum, cut out of the hernial sac. The method was applied in 30 patients in 2014-2017. There were no complications related to the inflammatory reaction to the synthetic material during the postoperative period.
Voenno-medicinskij žurnal. 2018;339(10):28-31
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Voenno-medicinskij žurnal. 2018;339(10):31
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Organization of medical care for infectious patients in the second stage of the stay of a Limited contingent of Soviet troops in Afghanistan

Lyashenko Y.I.


The second stage of the stay of a Limited contingent of Soviet troops in Afghanistan (1980-1985) was distinguished by the high combat activity of troops and the increased infectious morbidity. A large hospital base was created, which simultaneously managed to treat 1770 infectious patients and provided with resources to increase its capacity to 6000 beds. To timely isolate infectious patients and provide them with medical care, urgent hospitalization of servicemen with signs of an infectious process and mandatory medical examinations by personnel who returned from combat operations, raids and flights were introduced into practice. Evacuation of infectious patients to medical institutions from areas of combat operations and remote garrisons was carried out by sanitary helicopters. Traditional medical sorting in military hospitals was supplemented by the allocation of groups of patients with the presence of factors that adversely affected the infectious process (mixed infections, trophological insufficiency, etc.). Medical rehabilitation of typhoid fever was organized in medical institutions, which have the opportunity to implement it.
Voenno-medicinskij žurnal. 2018;339(10):32-38
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Voenno-medicinskij žurnal. 2018;339(10):38
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Main directions of development of pathogenetic means of arresting the primary reaction of the organism to irradiation

Drachev I.S., Legeza V.I., Turlakov Y.S., Chepur S.V.


The results of the study of the functional state of various regulatory systems of the organism during the primary reaction to irradiation are presented. In experiments on dogs and rats, the first activation of dopamine, serotonin and histamine was observed already in the first minutes and hours after irradiation at doses that triggered the development of symptoms of the primary reaction to irradiation (vomiting, diarrhea, gastrostasis, and hypodynamia) systems, increased release of opioid peptides and prostaglandins. Pharmacological blocking of these processes helps to prevent or reduce the severity of the main manifestations of the primary reaction to irradiation in experimental animals. Based on the data obtained, effective pharmacological agents have been developed to combat early clinical manifestations of irradiation.
Voenno-medicinskij žurnal. 2018;339(10):39-46
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Use of quantitative integral indices in the integrated assessment of the tolerance of the flight composition of overloads in a centrifuge

Churilov Y.K., Vovkodav V.S., Klepikov A.N., Richei I.I., Ryzhov D.I.


The efficiency of integral indices in the estimation of adaptive reactions and the tolerability of phase-increasing overloads in a centrifuge in 103 pilots of fighter aviation was analyzed. By background data heart rate in the pre-start period, 3 groups were formed - with average (n=62), elevated (n=16) and low (n=25) indicators. For pilots with an average and a low degree of prelaunch response under the influence of overloads, the group score according to the cardiac activity index was satisfactory - 14.8 and 13 conv., Respectively. units, with increased - bad - 17.9 conv. units Under the influence of overloads, the Hildebrandt index in the 1st and 3rd groups remained within the norm, in the 2nd group it exceeded the norm (5.9 conditional units) only under the influence of the overload in 3g. The «physiological price» of airworthiness with the flight crew of overloads with different types of response averaged 65-70%. Quantitative changes in integral indices in the process of increasing overloads objectively characterize the state of the adaptation process and can be used as additional criteria in assessing the professional health of the flight crew.
Voenno-medicinskij žurnal. 2018;339(10):47-56
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Voenno-medicinskij žurnal. 2018;339(10):56
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Problems of metrological support of military medical organizations

Levchenko V.N., Egorov O.Y.


Ensuring the uniformity of measurements in the treatment and diagnostic process allows obtaining reliable data on the patient’s condition. This causes an inseparable connection between metrology and medicine. The article deals with the problematic issues of metrological support for the medical service, while the main problem is identified - the absence of the main specialist-metrologist in this field of activity. Organizational and legal aspects of planning metrological maintenance of measuring instruments in military medical organizations and divisions are revealed. Management decisions on the optimization of the operation of metrological units of the medical service of the Armed Forces have been substantiated. As a result of the work, a coordinated and managed metrological support system for the medical service will be built, which will allow the heads of the medical service to have information about the state of medical equipment, use it safely and redistribute cash flows for its maintenance, verification and repair, get an economic effect.
Voenno-medicinskij žurnal. 2018;339(10):57-60
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On prevention of the incidence of community-acquired pneumonia among conscripts at the Arkhangelsk Territorial Garrison

Zakrevskii Y.N., Sitko O.V., Kukhanov A.V., Popov I.O.


Among the infectious diseases among conscripts performing military service on conscription, the incidence of respiratory diseases is the first. In the structure of diseases of the respiratory organs, the fourth place is occupied by community-acquired pneumonia. The frequency and causes of the incidence of community-acquired pneumonia in the Arkhangelsk Territorial Garrison, the scope and complex of measures to prevent the emergence and early detection of community-acquired pneumonia among conscripts are analyzed.
Voenno-medicinskij žurnal. 2018;339(10):61-63
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Optimization of patient adaptation to removable dentures

Iordanishvili A.K., Kuvshinova A.K., Volodin A.I., Grebnev G.A., Veretenko E.A.


Based on the analysis of the clinical picture during the period of habituation of 119 male pensioners of the Ministry of Defense of the Russian Federation (age 61-73 years) to partial and complete removable dentures, the influence of the cream for fixing dental prostheses «Korega» on the parameters of the adaptation period was studied. It is shown that when using the cream, the number of corrections of dentures decreases reliably, the duration of the adaptation period decreases and the indicators characterizing the fixation and stabilization of dentures improve. This makes it possible to recommend the use of the cream «Korega» in military medical organizations and dental offices for the prevention of traumatic prosthetic stomatitis and the optimization of the adaptation period for people using removable dental prostheses.
Voenno-medicinskij žurnal. 2018;339(10):63-65
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Assessment of the state of the autonomic nervous system in patients with severe forms of acne

Tarasenko G.N., Vasilyeva E.S., Kulikova N.G., Belyakina E.S.


The results of a study of the state of the autonomic nervous system and psychological research in 56 patients with acne are presented. The syndrome of vegetative disorders according to A.M.Wein’s questionnaires (1999) was noted in 82% of patients with papulopa-stellate form of acne and in all patients with nodular form. Evaluation of the imbalance in the vegetative nervous system can serve as an important prognostic criterion of the course, the effectiveness of the treatment and the outcome of the disease and allows individualizing the approaches to therapy.
Voenno-medicinskij žurnal. 2018;339(10):65-67
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Result of surgical treatment of recurrent stones of the urinary reservoir of a patient with bladder cancer after ileocystoplasty according to Hemi Kock pouch

Protoshchak V.V., Kushnirenko N.P., Babkin P.A., Sivakov A.A., Kharitonov N.N., Rassvetaev A.V., Iglovikov N.Y., Karandashov V.K., Gozalishvili S.M.


The article presents data on modern approaches to treatment of invasive bladder cancer and associated postoperative complications. A case of surgical treatment of recurrent stones of the urinary reservoir with a patient with bladder cancer after ileocystoplasty according to Hemi Kock pouch is described. The main factors of stone formation are infection of urinary organs, hyperchloremic acidosis, salt deposition on non-absorbable seams and tantalum brackets. Features of operative removal of stones from the urinary reservoir are described. As a preventive measure of recurrent stone formation, thorough drainage of the urinary reservoir, correction of hyperchloremic acidosis, and periodic courses of antibiotic therapy are recommended.
Voenno-medicinskij žurnal. 2018;339(10):67-68
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Features of an in-depth medical examination of frame officers with a high and very high risk of cardiovascular disease

Popov A.P., Kucheruk T.V., Didenko O.I., Khachaturian L.E., Chernevich S.V., Tsygelnikova Y.V.


A study has been carried out which shows that it is advisable to start the detection of early stages of the violation of carbohydrate and lipid metabolism in officers not from the age of 40, as stipulated in the regulatory documents, but to include officers of all age groups in the program of medical examination if they have weighed heredity, arterial hypertension and hut body weight. To improve the detectability of cardiovascular risk factors, an expanded program of in-depth medical examination of officers of the age group up to 40 years is proposed.
Voenno-medicinskij žurnal. 2018;339(10):69-71
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Voenno-medicinskij žurnal. 2018;339(10):71
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Formation of the military hospital system in Russia in the first third of the XIX century

Kulnev S.V., Kryuchkov O.A.


The article is devoted to the development of the hospital business in the Russian army in the first third of the XIX century. The main directions for reforming military hospitals are reflected, the qualitative transition from the system of «treating wounded in situ» to the evacuation system was noted, which required the development of new types of hospitals and new principles for their application. The preconditions are indicated and the process of the appearance of permanent military hospitals in the theater of military operations, the first in the history of the nation, is considered.
Voenno-medicinskij žurnal. 2018;339(10):72-79
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Professor N.Ya.Chistovich (1860-1926) i traditsiya vrachebnogo podvizhnichestva v otechestvennoy meditsine

Borodulin V.I., Poddubny M.V., Topolyanskii A.V.


A biographical sketch is presented about one of the pupils and professors of the Military Medical Academy - outstanding therapist Nikolai Chistovich (1860-1926). His scientific teams developed various problems of the clinic of internal and infectious diseases, bacteriology and immunology. Four main directions of these researches are distinguished: physiology and pathology of blood circulation and testing of new cardiovascular agents, bacteriology and immunology, epidemiology and clinic of cholera, plague, typhus, etc., study of physiology and pathology of white and red blood. Special attention was paid to the tradition of selfless service to the patient, whose bright representative in Russia was N.Ya.Chistovich.
Voenno-medicinskij žurnal. 2018;339(10):80-84
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On the formation and development of the system of sanitary-epidemiological surveillance in the Strategic Missile Forces

Gnashko O.M., Kazantsev A.Y., Kachurovskii I.A., Aleksandrovskii V.G., Rascheslavskii B.Y.


The system of sanitary-epidemiological surveillance in the Russian Strategic Missile Forces was formed considering the organizational and staff structure of troops and areas of their deployment, the specifics of personnel service. The primary responsibility for assessing the sanitary and epidemiological situation and the development of appropriate preventive and anti-epidemic measures was assigned to the chief epidemiologist of the Russian Strategic Missile Forces and the 117th Sanitary and Epidemiological Laboratory established in 1968. In 2002, the laboratory was transformed into the 842nd Center of State Sanitary and Epidemiological Supervision of the Russian Strategic Missile Forces, which during the years of development and reformation has become one of the leading sanitary and epidemiological institutions of the Ministry of Defense. In 2010, after the reorganization of the system of state sanitary and epidemiological surveillance in the Armed Forces the 842nd Center of the State Sanitary and Epidemiological Supervision of the Russian Strategic Missile Forces was reorganized into the Department of Russian Federation Oversight Committee for Sanitation and Epidemiology (surveillance over the objects of the Russian Strategic Missile Forces) of 988 Center of the State Sanitary and Epidemiological Supervision of the Russian Ministry of Defense. The main task of the Department of the Russian Strategic Missile Forces of the Center of the State Sanitary and Epidemiological Supervision Department of the Strategic Missile Forces is a purposeful work to prevent, detect and suppress violations in the field of ensuring the sanitary and epidemiological well-being of military units and organizations of the area of responsibility.
Voenno-medicinskij žurnal. 2018;339(10):85-89
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Voenno-medicinskij žurnal. 2018;339(10):89
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Voenno-medicinskij žurnal. 2018;339(10):90
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All-army meeting of the main specialists of the therapeutic profile of the Armed Forces, dedicated to the 50th anniversary of the Emergency Situations Department of the Branch of the S.M.Kirov Military Medical Academy

Ovchinnikov Y.V., Tyrenko V.V., Krainyukov P.E.


The report on the June 2018, on the basis of the P.V.Mandryka Central Military Clinical Hospital the All-Army meeting of the main specialists of the therapeutic profile of the Armed Forces of the Russian Federation dedicated to the 50th anniversary of the Department of Urgent Conditions Therapy of the Branch of the S.M.Kirov Military Medical Academy. The main objectives of the collection were to study the contribution of representatives of the Moscow school of therapists to the solution of the current problems of the therapeutic pathology of civil and military time, to discuss the problematic issues of organization of medical care for patients with therapeutic profile in the Armed Forces, to develop the main directions of measures to reduce mortality from cardiovascular diseases in the Armed Forces, etc.
Voenno-medicinskij žurnal. 2018;339(10):91-96
pages 91-96 views

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