Vol 338, No 6 (2017)


Prospects for improving the medical support of troops (forces) in modern conflicts

Kulnev S.V., Soldatov E.A., Kanibolotskii M.N., Zhukov A.A.


The article deals with the construction and development of the medical support system for troops (forces) in modern military conflicts. The principles are substantiated and the factors influencing the development of the organizational structure of the medical support formations are determined. Requirements for their organizational structure are formulated.
Voenno-medicinskij žurnal. 2017;338(6):4-12
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Acute issues of emergency care delivery in a multidisciplinary military-medical organization.

Klipak V.M., Iskra E.G., Zherebko O.A., Yasakova M.V.


The article provides information on defined organizational basics for emergency care delivery (ECD) in a multidisciplinary medical organization according to experience of the ninth treatment-and-diagnosis center of the Ministry of Defense of Russia. Authors reviewed regulating documents concerning emergency care delivery and first aid delivery, analyzed the importance of knowing of algorithms and principles of emergency care delivery in emergencies and critical conditions. The system of emergency care delivery organized in the center is shown, work of the emergency care department and outpatient care department is analyzed, issues and ways for their solving are determined. Costs for emergency care department and outpatient care are calculated, net cost for the service «Call for doctor-nurse team of emergency care department and outpatient care» its calculation and direct and indirect costs.
Voenno-medicinskij žurnal. 2017;338(6):13-20
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Methodological approaches to development of standard surgical procedures in the practice of a multidisciplinary hospital.

Esipov A.V., Breskina T.N., Gabuniya N.Y., Stolyarova A.N., Kazakova T.V.


Control of the quality and safety of medical activities is one of the priorities in the work of medical organizations. It is shown that the solution of these problems is possible only on the basis of the implementation of the process approach in the management of the organization’s activities. The most important task is mastering the technology of developing standard surgical procedures (SSPs). The article presents methodological approaches to the development of SSPs as the basis for standardizing the processes of a multidisciplinary hospital that allows ensuring compliance with government requirements for quality control and safety of medical activities. The algorithm of work on their development, accepted symbolism, structural elements of SPP and their content are stated. The development of SSP development technology, their introduction into the practice of the medical organization will ensure a constant improvement of the quality and efficiency of its activities.
Voenno-medicinskij žurnal. 2017;338(6):20-24
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Delivery of mental health services to military servicemen in a multidisciplinary hospital.

Shamrey V.K., Kurasov E.S., Kobozova K.A.


The article provides information, which shows that a significant proportion of mental disorders are detected outside psychiatric institutions, and most patients with them are treated in general hospitals. The choice as a basic model of cardiac pathology is caused by a wide range of its severity (from minor functional disorders to life-threatening conditions) and high prevalence of comorbid psychopathological disorders. Based on the study of the structure of psychopathological disorders (with the use of the rhythmological model of depressive disorders), three principal periods of their formation in 307 military men with urgent cardiological conditions and mental disorders substantiate the fundamental principles of organizing psychiatric care in a multidisciplinary hospital. The application of the proposed model contributed to a significant improvement in the quality of life of servicemen, their psychometric indicators, and the dynamics of the underlying cardiological disease.
Voenno-medicinskij žurnal. 2017;338(6):25-32
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Clinical evaluation of seizure events based on EEG-video monitoring results.

Litvinenko I.V., Odinak M.M., Prokudin M.Y., Moiseeva A.M., Dyskin D.E., Bazilevich S.N., Berov V.I., Koshkarev M.A.


A clinical analysis of the seizure events recorded by the results of EEG-video monitoring in 72 patients with paroxysmal impairment of consciousness of different genesis was carried out. High informativeness (positive in 91.3%) of the sample with placebo in psychogenic non-epileptic states is shown. An algorithm for evaluating seizures is described, which consists of the analysis of sensory manifestations, vegetative changes, motor activity, speech disorders, assessment of the level of consciousness, the presence of amnesia for testing, and post-transient phenomena (aphasia, paresis, rubbing the nose, asymmetric end of the attack). The relationship between seizure vegetative manifestations (tachycardia, bradycardia) and the syndrome of sudden death in epilepsy is shown. It seems that the presence of hypermotor attacks associated with sleep is a rather specific feature of frontal epilepsy with nocturnal paroxysms. It has been postulated that the clinical semiology of seizures is defined as the localization of the epileptogenic focus and the spread of excessive neuronal discharge to symptomatogenic zones, and the individual functional architecture of the cerebral cortex.
Voenno-medicinskij žurnal. 2017;338(6):32-39
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Ultrastructural characteristics of red blood cells in community-acquired pneumonia in young persons

Geltser B.I., Kotelnikov V.N., Karpenko A.A., Kim A.P.


In modern scientific literature, there are few works devoted to the study of the influence of pathogenic factors on the CAP ultrastructural organization of erythrocytes. Using atomic force microscopy and Raman spectroscopy for the assessment of physiological functions at the molecular level and submolecular offer new opportunities to clarify the pathophysiological regularities of the formation of the clinical picture of the disease in different categories of patients.The study included 55 patients with CAP. At 30 people diagnosed with non-severe CAP, 25 - severe.The control group consisted of 20 healthy non-smoking volunteers of similar age. Atomic force microscopy and Raman spectroscopy to study the micromechanical characteristics of red blood cells and the intracellular chemical structure in young patients with community-acquired pneumonia. It was found that all the patients at the height of the disease significantly decreased the ratio of the modulus of elasticity and strength of adhesion and the elastic deformation of the red blood cell count increased significantly. These changes were particularly noticeable in severe community-acquired pneumonia. So, set the close correlation between the parameters of endotoxemia, the level of arterial hypoxemia and elastic properties of cell membranes. Convalescents after severe CAP has kept changes micromechanical properties of cell membranes, which are recovered only after 3 months from the hospital. It is shown that in the examined groupof patients intracellular chemical structure of the red blood cells did not differ from healthy individuals, which may indicate stability gemoporfirins metabolic profile in these patients.
Voenno-medicinskij žurnal. 2017;338(6):40-47
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About pyopneumothorax in patients with pulmonary tuberculosis.

Polyanskiy V.K., Savitskiy G.G.


Under our supervision, there were 349 patients with pulmonary tuberculosis, of whom 57 (16,3%) had a tuberculous process complicated by spontaneous pyopneumothorax. The age of the patients was 18 to 52 years. There were 55 men, women - 2. Right-sided localization took place in 26, left-sided - in 31 patients. Limited pyopneumothorax was diagnosed in 21,1% of patients, prevalent in 56,1% and total - in 22,8%. Complex treatment of patients with tuberculosis pyopneumothorax consisted in measures aimed at sanitation of the purulent cavity, full etiotropic and pathogenetic therapy, intensive correction of syndrome disorders of homeostasis. The general treatment of patients with tuberculous pyopneumothorax was strictly pathogenetic. Early diagnosis, immediate transfer of patients with pyopneumotorax to specialized phthisiosurgical hospitals and a differentiated approach to treatment choice led to good treatment results.
Voenno-medicinskij žurnal. 2017;338(6):48-54
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Voenno-medicinskij žurnal. 2017;338(6):54-54
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Military epidemiology now and then.

Ogarkov P.I., Kuzin A.A., Ishkildin M.I.


The article provides retrospective characteristics of works written by Russian and foreign physicians, which became a basis for epidemiology. A significant contribution into development of knowledge about mass infectious diseases in XVIII-XIX centuries made: Ya.V.Villie, R.O.Yagelskiy, P.I.Pogoretskiy, A.G.Bakherakht, S.S.Andreevskiy, I.I.Vien, G.N.Minkh, O.O.Mochutovskiy. Also were highlighted works of N.I.Pirogov, S.P.Botkin, A.P.Dobroslavin, S.V.Shidlovskiy, V.A.Levashev, G.V.Khlopin, Ya.L.Okunevskiy. The authors described stages of development of epidemiology as a science and formation of its teaching in the Military-medical academy: establishment of department of contagious diseases and medical bacteriology in 1894, splitting of this department into two departments in 1923 - department of microbiology with epidemiology and infectiology (the head of department - D.K.Zabolotniy) and department of contagious diseases, and formation of independent department of epidemiology (heads of department - V.M.Berman, I.Z.Tsybulko-Nechai, G.A.Znamenskiy, I.I.Rogozin, V.D.Belyakov, D.T.Khokhlov, V.F.Korolkov, P.I.Ogarkov). The authors provided information on experience in training of staff for the medical service of the Armed Forces and modern direction of scientific researches in the field of epidemiology.
Voenno-medicinskij žurnal. 2017;338(6):55-63
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Ways of improvement of medical facilities support with infusion solutions.

Miroshnichenko Y.V., Umarov S.Z., Kirillova Y.L.


It is shown that an objective condition for ensuring the quality of medical care is an objective determination of the need for medicines, including those in infusion solutions, many of which are essential medicines. It is established that to determine the need for infusion solutions, a significant factor is the balance between the assortment and the number of acquired infusion solutions and the content of standards of specialized medical care, on the basis of which the medical organization carries out medical activities. The necessary data are presented to determine the indices of the need for infusion solutions, the main factors influencing the structure of their consumption, the mathematical formula for calculating the need for infusion solutions for a specific nosology.
Voenno-medicinskij žurnal. 2017;338(6):64-67
pages 64-67 views

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Voenno-medicinskij žurnal. 2017;338(6):67-67
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The concept of «hybrid war»: the rise, evolution and modern state

Anisimov A.S., Golota A.S., Krassii A.B., Parfenov V.D., Soldatov E.A., Shalakhin R.A.


The current paper is dedicated to analysis of the concept of «hybrid war». The aim of the article is to determine whether it is reasonable to employ this term in the domestic scientific discourse. The research has been based on free available foreign scientific publications. It has been established that the term «hybrid war» does not represent any definite subject matter. Different scholars put different meanings into it. Because of such vagueness the term has not been used in the official documents of the world largest armed forces, such as armies of the USA, member states of NATO, and People’s Republic of China. So it is inexpedient to use the term «hybrid war» in domestic science as well. Instead uncritical borrowing of fashionable foreign linguistic constructions it would be wise to endeavor the serious theoretical and applied research to build our own, Russian-language, terminological field which will adequately reflect the modern war and armed conflict phenomenology. And only after should one start on elaboration of the military medical aspects of the theme.
Voenno-medicinskij žurnal. 2017;338(6):68-70
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Complex lymphotropic and NO-therapy of purulent-inflammatory diseases of soft tissues in the field.

Zuev V.K., Musailov V.A., Moskalenko V.V.


The author presents his own experience of surgical treatment of patients with pyoinflammatory soft tissue diseases in the field using lymphotropic and NO-therapy. The comparative characteristic of treatment of two groups of patients is described: the first - 18 patients with pyoinflammatory diseases of soft tissues, who were treated with the traditional modern method (surgical treatment and drainage of the focus, cefotaxin intramuscularly); The second - 34 patients underwent complex NO- and lymphotropic therapy. After surgery, lymphotropic administration of 1 g of cefotaxime was performed, and a day later the lymphotropic administration of the antibiotic was repeated and the wounds treated with air-plasma streams using the Plazon apparatus in a gentle coagulation regime or in the NO-therapy regime. The first group of patients was prescribed on the average on the 12th day after the start of treatment, and the second on the 8th day, which indicates that the treatment method used by us allows us to shorten the treatment time for patients with pyoinflammatory soft tissue diseases.
Voenno-medicinskij žurnal. 2017;338(6):72-73
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Treatment of accommodative asthenopia in far-sightedness in operators of optical hard work.

Yudin V.E., Ovechkin I.G., Malyshev A.V., Grischenko I.V.


The article provides information on scientific evidence of complex treatment of accommodative asthenopia in military specialists - operators of optical profile with far-sightedness. Achieved data testify the necessity of non-specific methods of correction (relaxitation) psycho-emotional patient’s condition along with standard specific method of visual organ.
Voenno-medicinskij žurnal. 2017;338(6):73-75
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Evaluation of the effectiveness of osteopathic treatment of military woman with different types of pathology

Matvienko V.V., Buchnov A.D., Yudin V.E., Kats A.V.


Evaluation of the effectiveness of osteopathic treatment of 50 military women aged 30 to 40 years with different types of disease: psychophysiological insomnia, a syndrome of chronic venous discirculation of brain, adhesive disease of the pelvic organs (operation history about 10-12 years ago) due to uterine myoma and cyst one or both ovaries. With the help of a question naire SF-36 was assessed in the dynamics of indicators of quality of life be fore and after osteopathic treatment. According to the correlation and factor (principal components) analyses the peculiarities of inter relations of indicators of the osteopathic status and quality of life before and after osteopathic treatment.
Voenno-medicinskij žurnal. 2017;338(6):75-78
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The Kronstadt navy hospital celebrates the 300th anniversary.

Lyutov V.V., Roskostov M.V.


Peter the First founded the Kronstadt navy hospital in the period of formation of the Russian Navy. Such outstanding medical scientists as Bush I.F., Shein M.I., Maksimovich-Ambodik N.M., Isaev V.I., Podkopaev N.A., Orbeli L.A., Polenov A.L., Girgolav S.S., Lubo V.K. and others worked in the hospital. For the first time ever in the hospital was performed pericardiocentesis, received a plague vaccine and implemented water chlorination. Medical education and the Kronstadt hospital are closely welded. In 1733 in the Kronstadt hospital was established a hospital training school for medical staff working in the army and the navy. Establishment of the military physicians society in 1859 also contributed into medical science development. During the Great Patriotic War more than 40 thousands of soldiers and sailors were treated in the Krondstadt hospital and returned to the ranks. In 1942 the hospital became the first navy hospital awarded with the Order of Lenin. Today the hospital staff redounds traditions of previous generations and successfully solves medical equipment issues.
Voenno-medicinskij žurnal. 2017;338(6):79-83
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From the history of the Branch N 2 of the N.N.Burdenko Main military clinical hospital.

Beznosik R.V.


The article presents the main stages of formation and development of the antiphthisic specialized multidisciplinary military-medical organization. Within the last 65 years the staff of the brach has admitted for treatment mote than 40 thousands of patients with tuberculosis and performed about 15 thousands surgical treatments. For the last years the facility has become not only clinical but also methodological antiphthisic center in the Armed Forces of the Russian Federation.
Voenno-medicinskij žurnal. 2017;338(6):84-87
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Health resort «Zvenigorodskiy» of the therapeutic resort complex «Podmoskovie» of the Ministry of Defense of Russia celebrates the 70th anniversary.

Titov I.G., Kazantsev V.I.


The article is devoted to the history of formation and development of the military health resort from the moment of establishment of a recovery center of the Armed Forces of the USSR till the moment of transformation of this facility into a branch of the therapeutic resort complex «Podmoskovie» of the Ministry of Defense of Russia. Authors provided information on facility’s activity aimed to improve health resort treatment and rehabilitation of military personnel, retired military personnel and members of their families.
Voenno-medicinskij žurnal. 2017;338(6):88-90
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Kotiv B.N., Tsygan V.N., Iordanishvili A.K.
Voenno-medicinskij žurnal. 2017;338(6):91
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Zverev D.P., Shitov A.Y., Andrusenko A.N.
Voenno-medicinskij žurnal. 2017;338(6):91-91
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Voenno-medicinskij žurnal. 2017;338(6):92-92
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Research and practice conferences «Current issues on military and practical medicine» of physicians of the Central military district in Orenburg (1995-2016).

Kalmykov A.A., Rychkov V.V., Stepanov A.V.


The authors provided a report on the XVI research and practice conference «Current issues on military and practical medicine» of physicians of the Central military district. The conference has been held traditionally in Orenburg since 1995. The program of the last conference, which was held in December 2016, included reports of the Military-medical academy’s representatives, the medical service of the Central military district, professors and teachers of the Orenburg state medical university, physicians of treatment-and-prophylaxis facilities of the medical service of the military district and Orenburg district. During the conference was organized instructor group workshop «Organization of work of military-medical facility under condition of the strict antiepidemic regime». The materials dedicated to the conference are published in «Informational archive» journal (2016).
Voenno-medicinskij žurnal. 2017;338(6):93-96
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