Vol 338, No 4 (2017)


Organization of sanitary and aviation evacuation in the Armed Forces

Kuvshinov K.E., Sushilnikov S.I., Yakovlev S.V., Isaenkov V.E., Bobrov Y.M.


The current state is examined and the organizational experience of the sanitary and aviation evacuation is analyzed, as well as the equipment for carrying out the evacuation. The problematic issues of the organization of sanitary, aviation evacuation are identified, and prospective directions of its development and improvement in the Armed Forces in peacetime are outlined.
Voenno-medicinskij žurnal. 2017;338(4):4-11
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Military medical examination in case of the central retinopathy

Ignatev S.A., Kabalin A.P., Chaplyuk A.L., Koryakin S.V., Nam Y.A.


It sets out the pathogenesis, risk factors for age-related macular degeneration. The scheme of the mechanism of degeneration, which allows you to understand the underlying pathogenesis and in the future can be used to assign adequate treatment: antiviral, suspension of cholesterol deposition in retinal layers, the use of drugs against chronic neovascularization, etc. The questions of the military-medical examination for determining of fitness for military service personnel with retinal disorders caused by age-related degeneration are discussed.
Voenno-medicinskij žurnal. 2017;338(4):11-17
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Peculiarities of diagnosis and treatment of kidney cancer in the central military hospital

Esipov A.V., Kochetov A.G., Sitnikov N.V., Karandin V.I., Nesterenko V.N.


The information about the features of tumor based on analysis of the treatment of patients with kidney cancer in 1339 received. Studied the characteristics such as the stepwise distribution of patients, incidence of histological types of kidney cancer, and varying degrees of tumor differentiation, the proportion of organ and organ-resecting interventions, methods of drug treatment, adoptive immunotherapy.
Voenno-medicinskij žurnal. 2017;338(4):18-21
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Indicators of the quality of life of patients with chronic biliary pancreatitis after various options for surgical treatment

Ivanusa S.Y., Lazutkin M.V., Shershen’ D.P., Eliseev A.V., Goltsov V.R.


Quality of life indicators of patients (n=365) with chronic biliary pancreatitis before the operation, 6 months and up to 10 years after surgical intervention were studied. It was found that the decrease in the quality of life of patients before surgery is mainly due to pain syndrome. After 6 months after the operation, the work capacity and physical activity are gradually restored against the background of a reduction in the pain syndrome. In the late period, the greatest importance is acquired by dyspeptic disorders and reduced physical performance. The use of minimally invasive technologies leads to a faster recovery of the quality of life indicators of patients in the postoperative and remote periods, the use of minimally invasive techniques and the dissociation of the common biliary and pancreatic ducts do not have significant differences and are close to the norm. The worst quality of life was observed in patients who underwent the imposition of choledochusduodenoanastomosis.
Voenno-medicinskij žurnal. 2017;338(4):21-27
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First experience of using cardiorespiratory load testing to assess the functional status of the patient in the pre-operational period

Tsygankov K.A., Shchegolev A.V., Makarenko E.P., Lakhin R.E., Averyanov D.A.


In anesthetics practice exist different scales and indexes, through which the evaluation functional condition of the patient. The disadvantage of these scales and tests are subjective evaluation as a condition of the patient, who is able to re-evaluate their functionality and anaesthesiologist, co-tory may underestimate the presence of comorbidities and patient complications in the postoperative period. The method of improvement of objective assessment of the patient’s functional reserves of a cardiorespiratory exercise testing is given. The methodology of testing in 18 patients, who were later performed surgery on the abdominal organs. The definition-of anaerobic threshold was conducted using V-slope method. In all cases was reached and was 11,1 (10,1; 12) ml/kg/min. Maximum oxygen consumption was 15,7 (15,2; 18,3) ml/kg/min. The results show the possibility of using the selected duct la research to predict possible complications and post-operative period.
Voenno-medicinskij žurnal. 2017;338(4):27-32
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Treatment of patients with pathology of respiratory and blood circulation in sanatorium complex «Crimean» of the Ministry of Defence of the Russian Federation

Terganov K.A., Kolomytsev A.Y., Tyukina A.K.


The article presents a brief description of the sanatorium organizations CCM «Crimean» the Ministry of Defence. Analysed the climatic characteristics of the region, as well as climatotherapeutic, balneological and other factors used in sanatorium treatment of diseases of the respiratory and circulatory. Evaluate the structure receiving spa treatment, patients’ opinions about its effectiveness.
Voenno-medicinskij žurnal. 2017;338(4):33-36
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Clinical and epidemiological characteristics of hemorrhagic fever with renal syndrome in the North-West region of Russia

Rudakov Y.V., Shelukhin V.A., Shishkin M.K., Popov S.I., Kann E.A., Zhanzharov K.V., Mal’tseva O.A., Konushkaliev A.A.


The data of the literature and our own research of clinical and epidemiological features of hantavirus infection in the North-West region of Russia, showing the loss of endemicity of hemorrhagic fever with renal syndrome. It is noted mostly airborne infection in young and middle-aged men, year-round nature of the disease with seasonal peaks. The clinical picture is moderately prevalent the disease with no or minimal systemic manifestation of hemorrhagic syndrome, often marked by thrombocytopenia, moderate dysfunction and kidney damage in half the time without reducing urine output. The introduction of acute kidney damage concept allows significantly improve the diagnostic efficiency and stratification of renal dysfunction severity in patients with hantavirus infection.
Voenno-medicinskij žurnal. 2017;338(4):37-43
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Provision of personalized acoustic protection of aviation specialists (practical aspects)

Ponomarenko V.A., Soldatov S.K., Filatov V.N., Bogomolov A.V.


In the article observed the issues of individual protection of aviation technical personnel from the noise generated by military aircrafts. It is shown that modern innovative materials and technologies allow carrying out scientifically based selection of perspective acoustic protection means for aviation personnel. Conducted analysis has shown that specially designed aviation PPE are comparable by acoustic effectiveness with foreign analogs. The necessity of taking into account of personal psycho-physiological features in the process of designing, building and testing of PPE has been proved. Stress-protective function of acoustic protective equipment has been proved in experiments with aviation specialists. Discussing prospective investigation directions in the field of noise protection. One of them is the establishment of persons register (flight and technician personnel) working in acoustically adverse conditions as the basis for occupational risks management.
Voenno-medicinskij žurnal. 2017;338(4):44-50
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Voenno-medicinskij žurnal. 2017;338(4):50-50
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Medical Aspects of Flight Safety

Blaginin A.A., Lizogub I.N.


One of the priorities of aviation medicine is medical safety of flights. The article presents the results of an analysis of current trends and the main lines of activity of the medical service for ensuring the safety of flights. The problematic issues of medical control over the health of aviation specialists have been identified and ways of their solution have been proposed.
Voenno-medicinskij žurnal. 2017;338(4):51-55
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Voenno-medicinskij žurnal. 2017;338(4):55-55
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The substantiation of organizational and methodological approaches to the development of standards for the supply of medical equipment tо provide educational activities in the Military Medical Academy

Miroshnichenko Y.V., Kononov V.N., Gaidamovich N.N., Lobachev I.V., Gainov V.S., Likhogra I.A.


The article shows that one of the conditions for qualitative training of specialists for the medical service of the Armed Forces of the Russian Federation is the availability of a well-equipped material and technical (teaching and material) base, the main element of which is medical property. It was revealed that at present the nomenclature, quantity and medical and technical characteristics of medical educational material for implementation of educational activities in the Military Medical Academy are not defined by normative legal acts. It is established that the formation of the material and technical (educational-material) base academy should be carried out on the basis of the principle of standardized allowance, which will allow the military management bodies to plan the allocation of not only the relevant medical educational equipment, but also the necessary amounts of money.
Voenno-medicinskij žurnal. 2017;338(4):56-61
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Voenno-medicinskij žurnal. 2017;338(4):61-61
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Characteristics of health and quality of life of modern pre-conscripts and draftees

Bulavin V.V., Vorona A.A., Kal’manov A.S., Zapechnikova I.V., Dudelzon V.A.


Presented modern data characterizing the state of somatic health and the psychological status of young men of pre-conscription and draft age. The unfavorable dynamics of the obtained indices with increasing age is shown. Their connections with the quality of life of young men are studied. Sanitary and hygienic living and living conditions of young men have been analyzed and evaluated.
Voenno-medicinskij žurnal. 2017;338(4):63-64
pages 63-64 views

Experience in using a medical aircraft module in a military hospital

Petrov P.A., Pak R.V., Klochkov D.A., Gadzhimagomedov M.G.


The experience of using a module of medical aircraft for evacuation of seriously ill patients by air transport, accompanied by a formed anesthesiology and resuscitation team, is outlined. The use of the module and the brigade allows ensuring during the evacuation the maintenance of the vital functions of the patient’s body.
Voenno-medicinskij žurnal. 2017;338(4):64-66
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Difficult to diagnose spinal fractures occurred when catapulting

Korzhenyants V.A.


Ejection attitude doesn’t allow avoiding spinal injuries. Research of experimental influence of vertical pressure load on relatively straight three spinal bone lumbar areas showed that the intervertebral cartilage core plays main traumatic role. At the beginning occurred a sag in the center of vertebral end plate, then its damage, and finally fracture in the center of spinal bone. Spinal fracture occurred relatively rare in pilots. More often spinal damages are external cracks and small sags on vertebral end plate, which are not determined by ordinary X-ray and can proceed asymptomatic. Further these damages can cause degenerative dystrophic processes in the spinal cord in the form of osteochondrosis and Schmorl’s nodules.
Voenno-medicinskij žurnal. 2017;338(4):66-68
pages 66-68 views

Impact of aircraft noise on the body of the flight and engineering personnel carrier-based aircraft

Plakhov N.N., Glaznikov L.A.


The evaluation of the impact of aircraft noise on the auditory analyzer, performance and function of the body for flight and engineering personnel carrier-based aircraft. It is shown that the pilots and engineering staff, provides flight deck aircraft, experiencing the harmful effects of aircraft noise on the body, which is expressed in a significant deterioration of specific performance function of the auditory analyzer, the functional state of the organism as a whole, especially in the central nervous and cardiovascular systems and said health professionals. This dictates the need to develop effective means of individual protection against aircraft noise.
Voenno-medicinskij žurnal. 2017;338(4):68-70
pages 68-70 views

Features of microcirculation after a single replenishment of acute blood loss by gelatin-based blood substitute in the experiment

Shperling I.A., Galaka A.A., Solov’ev I.A., Krupin A.V., Shperling M.I., Gabrielyan M.A.


Were identified the features of the microcirculation in the vessels of the tongue of dogs after acute blood loss replenishment for 4,2-4,8% by weight of the animal (50-60% of blood volume) by experimental blood substitute based on modified gelatin. It was found that a single infusion of the experimental blood substitute in the ratio of the volume of blood loss: replenishment of 1:1, had improve microcirculation in the vessels of the tongue within 24 hours of observation, reaching the level of normal values, and a number of parameters - were exceeding it. This normalization of the microcirculation occurs due to physiological regulation mechanisms of tissue microperfusion. The microcirculation recovery in the tongue vessels in dogs without replenishment of acute blood loss was less pronounced, and occurred due to the stress functioning of the physiological mechanisms of the critical state compensation. The assumption was made about the effectiveness and safety of the gelatin substitutes in a complex of measures to fill the acute blood loss in severe injury or damage, including requiring antiedematous therapy.
Voenno-medicinskij žurnal. 2017;338(4):70-73
pages 70-73 views

On the narrative ethics of the relationship between the doctor and the patient

Andreev S.I., Dondokova B.B., Odnostalko M.A.


The authors analyzed modern concepts and theories of ethics. Specific ethical aspects of the doctor’s and patient’s interaction are marked, which are evaluated from the point of view of the individual moral position and in accordance with the canons of public morality, as well as ethical principles of professional activity. In conclusion, attention is paid to ethical reflection, which in turn is one of the most effective strategies for creating the moral experience of subjects of medical communication.
Voenno-medicinskij žurnal. 2017;338(4):73-74
pages 73-74 views

Сase of tuberculosis combined with HIV infection

Grabovskaya M.S., Motanova L.N., Zabolotskii Y.N.


The clinical case of tuberculosis combined with HIV infection is described. It is shown that the conduct of rational individualized treatment regimens, including antiretroviral and TB treatment, provided the patient’s adherence to treatment and timely elimination of adverse reactions, it is possible to achieve high efficiency.
Voenno-medicinskij žurnal. 2017;338(4):74-78
pages 74-78 views

Last autograph of the epistolary heritage of N.I.Pirogov

Kozovenko M.N., Trikhina S.I.


The epistolary heritage of N.I.Pirogov includes several letters, the subjects of which are connected with the national question. The last of these in the literature of the pre-Soviet period was called «letters on the Jewish question» or a draft copy of the letter to an unidentified person (without place and date). This relic in 1897-1930 was kept in the Museum of N.I.Pirogov. During the Soviet era, the letter was not published, and its bibliographic description was absent in the indexes of the Pirogov epistolary heritage. The authors of the article established for the first time: the addressee (L.A.Miloradovich), the place and time of writing the letter by Pirogov, as well as the circumstances in connection with which it appeared. The present location of this Pirogov’s relic remains unknown.
Voenno-medicinskij žurnal. 2017;338(4):78-80
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Voenno-medicinskij žurnal. 2017;338(4):80-80
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Naznacheniya. Yubilei

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Voenno-medicinskij žurnal. 2017;338(4):81-82
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Voenno-medicinskij žurnal. 2017;338(4):83-83
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Hygienists of the Military Medical Academy - participants in the liquidation of the consequences of the Chernobyl accident

Kuznetsov S.M., Petreev I.V., Terentev L.P.


The main task of the military medical service in the area of work to eliminate the consequences of the Chernobyl nuclear power plant disaster was to organize and carry out sanitary and hygienic measures aimed at preventing radiation exposure to liquidators-military personnel in excess of the established dose limits and the emergence of mass infectious and non-infectious diseases. The article summarizes the experience of the participation of the employees of the S.M.Kirov Military Medical Academy in the implementation of anti-radiation and other preventive measures in the area of the accident. The entire faculty of the Department of Naval and Radiation Hygiene and a number of employees of the Department of General and Military Hygiene, who on a rotational basis were continuously in the zone of work to eliminate the consequences of the accident, went through the mill of Chernobyl. Their personal contribution to the solution of urgent scientific and applied problems of minimization of radiation impact and preservation of health of servicemen-liquidators of the accident were noted.
Voenno-medicinskij žurnal. 2017;338(4):84-89
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From the history of the buildings of the Mandryka Central Military Clinical Hospital

Krainyukov P.E., Abashin V.G., Simonenko V.B.


The article deals with the history of the complex of buildings of the Mandryka Central Military Clinical Hospital located in Moscow’s Serebryany and Krivonikilskiy lanes. Famous historical figures, physicians and writers whose names are associated with the buildings of the hospital are listed. In 2014, the Moscow government commission decided to recognize the architectural monuments of the building of the surgical hospital and the income house of MD S.M.Rudnev and the income house of A.R.Lednitsky, currently part of the architectural ensemble of the hospital.
Voenno-medicinskij žurnal. 2017;338(4):89-93
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To the history of the Research and Testing Laboratory of Psychophysiological Support of Flight Operations

Zasyadko K.I., Vonarshenko A.P., Boreichuk A.F., Yazlyuk M.N., Flenov E.A.


The brief history of the first research and testing laboratory (psychophysiological support of flight activity) of the Scientific Research Testing Center (aerospace medicine and military ergonomics) celebrating its 55th anniversary is presented. The laboratory, which is now located in Lipetsk allows specialists of the Research and Testing Center carrying out a wide range of studies on its basis on ergonomic provision of combat effectiveness and flight safety of flight crews, studying the influence of flight work on the pilot’s organism and its performance in normal and extreme conditions in close interaction in Highly skilled employees of other institutions of the Ministry of Defense.
Voenno-medicinskij žurnal. 2017;338(4):93-96
pages 93-96 views

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