Vol 338, No 8 (2017)


Issues on organisation of surgical care delivery to severely injured under condition of modern hybrid war

Samokhvalov I.M., Goncharov A.V., Golovko K.P., Gavrilin S.V., Severin V.V., Suprun T.Y., Loshenko Y.A.


Based on the experience of providing surgical care to more than 5500 battle casualties in operations of recent decades, the structure of modern combat trauma, the nature of life-threatening consequences and the preventable causes of the lethality are presented. It is shown that the key to solving the problem of improving the outcomes of seriously wounded management in a hybrid war is high-tech prehospital care, pushing forward surgical care and creating the Joint medical information system. Perspective technologies of military medicine in the combat zone are presented.
Voenno-medicinskij žurnal. 2017;338(8):4-11
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Evaluation of subjective criteria of patients’ attitude to catering at health resorts.

Nagibovich O.A., Kirichenko N.N., Pervova V.M., Pavlov A.V., Glukhova N.I., Glukhova N.I.


A comparative analysis of the «traditional» nutrition system in health resort organizations and the food system as a «buffet» is presented. When examining 452 patients in health resort for both food systems, there was no significant dynamics of objective indicators. Improvement of subjective evaluation criteria on SF-36, SUN scales, reduction of gastroenterological syndrome severity on the GSRS scale in a sanatorium where the «buffet» food system is applied has been established.
Voenno-medicinskij žurnal. 2017;338(8):12-17
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Voenno-medicinskij žurnal. 2017;338(8):17-17
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Algorithm of diagnostics and rational tactics of surgical treatment of patients with carbon-vertebral syndrome in military medical organizations

Khominets V.V., Kudyashev A.L., Shapovalov V.M., Metlenko P.A., Miroevskii F.V., Teremshonok A.V., Rezvantsev M.V.


The results of treatment of 565 patients (362 men and 203 women) with one- and two-sided coxarthrosis of the III stage of various etiology were studied, with which total hip arthroplasty was performed in the period 2009-2016. In 175 patients, coxarthrosis was combined with chronic lumbargia in the background of degenerative-dystrophic spine disease and was manifested by carbon-vertebral syndrome. Recommendations for surgical treatment of patients with carbon-vertebral syndrome in military medical organizations have been developed. The proposed system of diagnosis and selection of rational tactics for surgical treatment of patients with a combination of degenerative-dystrophic hip and spinal pathology allows to optimize the organization of treatment of patients of this profile, to achieve improvement of the anatomical and functional results achieved.
Voenno-medicinskij žurnal. 2017;338(8):18-24
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Heart rate variability as an indicator of the condition of patients with severe burn injury.

Pugachev M.I., Livarskii A.P., Salukhov V.V., Ivchenko E.V., Kharitonov M.A., Shustov S.B.


The results of the study of spectral parameters of heart rate variability in patients with burn disease and their dependence on the severity of the burn are presented. It is shown that with a burn injury, the wave structure of the heart rate and the total power of the spectrum are suppressed. The degree of oppression depends on the severity of the burn injury. A correlation was found between the severity index of the state and the values of the power of the spectrum in the low and high frequency ranges and the total power of the spectrum of the heart rate variability. It was shown that heart rate variability has a predictive value due to the correlation between the adverse outcome and the heart rate variability indices when entering the hospital. A mathematical model is proposed for estimating the severity of a condition burned with the definition of the probability of a lethal outcome.
Voenno-medicinskij žurnal. 2017;338(8):24-33
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Increasing the resistance to low ambient temperatures in military men with different sensitivity to normobaric hypoxia

Samoilov V.O., Maksimov A.L., Golubev V.N., Korolev Y.N., Maksimova N.N., Borisenko N.S., Timofeev N.N.


The article presents the results of the study of individual and average parameters of variability of functional response of saturation of hemoglobin with oxygen during the classical hypoxic test, as well as options of hands’ temperature reconstructions and heart rate variability in military higher school students. The study was performed before and after trainings with breathing in a closed space without carbon dioxide absorption (rerespiration). It is determined that trainings with rerespiration increase cold resistance by influencing on body’s temperature and its aftersensations last out up to 3 weeks. This is accompanied by the correction of heart rate regulation due to the shift of regulatory influences of autonomic nervous system towards normotonic reactions. Picture of thermal structure of hand during local cold exposure after trainings with rerespiration indicates the absence of vasoconstriction effects, which are clearly manifested during decreasing of an averaged hand’s temperature. Conducted researches have shown that trainings with breathing in a closed space without carbon dioxide absorption in patients with initial vagonormotonic type of autonomic nervous regulation do not practically affect the heart rate variability during local cold exposures, but rerespiration promotes significant increasing of body’s temperature. Using trainings with rerespiration can be an effective method to increase not only the cold, but also the hypoxic-hypercapnic human’s resistance that can serve as the basis for the preparation and selection of special troops for operations in extreme environmental conditions, including the Arctic regions.
Voenno-medicinskij žurnal. 2017;338(8):34-43
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Voenno-medicinskij žurnal. 2017;338(8):43-43
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Actual issues of medical-flight expertise in aortic regurgitation.

Ovchinnikov Y.V., Chaplyuk A.L., Nagovitsyn A.V., Vovkodav V.S., Chernov M.Y., Antonik E.Y.


Aortic regurgitation (AR) is of particular relevance in determining the fitness for flight work. According to author’s long-term observations, the most common causes of it are military congenital anomalies of the aortic valve (AK), its age-related degenerative changes and systemic arterial hypertension. A large group of experienced flight specialists with a small AP without morphological changes of the AK annually is at risk of professional disqualification. In order to unify the clinical and expert approaches, three clinical variants are distinguished during the survey of the flight crew with AR: trace regurgitation on tricuspid AK, with asymptomatic flow and absence of morphological changes in the valve; Trace or insignificant AR on bivalvia, as well as insignificant AR on tricuspid AK, with asymptomatic flow and absence of morphological changes in the valve; moderate or more severe AR, as well as a minor AR, combined with one or more disorders (changes in the morphology of the valve, myocardial hypertrophy of the left ventricle, dilatation and / or dysfunction of the heart chambers, dilatation of the root or tubular part of the ascending aorta, significant cardiac arrhythmias Or conduction, pulmonary hypertension, negative dynamics of echocardiographic indicators, etc.).
Voenno-medicinskij žurnal. 2017;338(8):44-51
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New approach for calculation of decompression modes for diving

Litoshko I.A., Golovyashkin G.V., Motasov G.P.


The paper contains some results of theoretic and experimental studies in calculating and testing of new decompression modes for RF Navy and Emergency diving. New recomendations for decompression modes for diving bounce oxygen/nitrogen or nitrogen/helium gas-mixtures. A mathematical model for calculations was modified to consider the total (summary) saturation of soft biological tissues of the human organism. The main problem was to evaluate the parameters of the suggested model in order to even the individual variations. The findings include a number of recommendations for practical needs. The results were transformed into new decompression tables and tested successfully under laboratory conditions in hyperbaric chamber.
Voenno-medicinskij žurnal. 2017;338(8):51-59
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Voenno-medicinskij žurnal. 2017;338(8):59-59
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Modern system of reserves and medical supplies for use in emergency situations.

Chizh I.M., Goryachev A.B., Lemeshchenko E.Y., Afanasev O.N., Kabakova T.I.


The characteristics and analysis of the existing system of separation of reserves and medical supplies are presented in terms of the levels of operation of the All-Russian Disaster Medicine Service and the methodology of their formation for use in emergencies. The nomenclature of the federal reserve of medicines and medical products of the Ministry of Health of the Russian Federation is analyzed. An approach to the content of reserves at the interregional and regional levels is shown. On the example of the Department of Health of Moscow, the specifics of the content of irreducible stocks of medical property at the municipal level and providing them with medical organizations that carry out mass reception of victims in emergencies are disclosed.
Voenno-medicinskij žurnal. 2017;338(8):60-66
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Voenno-medicinskij žurnal. 2017;338(8):66-66
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Military medical journals abroad. From the origin tothe present day.

Aleinikov S.I., Golota A.S., Krassii A.B., Morovikova T.V., Shalakhin R.A.


The current article is dedicated to the history of military medical journals from the first published in France in 1782 to the present time. The dates of publication of the first military medical journals in the main European languages have been mentioned. The list of full text military medical journals freely available in the net is presented. It is stated that the overwhelming majority of military medical periodicals are not indexed in international databases. Thus the devoted professionals are encouraged to create their personal libraries of articles from the foreign military medical journals.
Voenno-medicinskij žurnal. 2017;338(8):67-72
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Results of surgical treatment of patients with diffuse toxic goiter

Skorobogatov V.M., Barsukov A.N., Gurgenidze V.V.


Retrospective analysis of the results of complex therapeutic and surgical treatment of 170 patients with diffuse toxic goiter was carried out. The validity is shown in the presence of indications of the performance of all thyroidectomy as the most justified surgical benefit followed by adequate medication correction of postoperative hypothyroidism. The use of the integral method of treating patients with diffuse toxic goiter improves the quality of medical care provided to them, optimizes approaches to intra- and postoperative management of patients, and positively affects the long-term prognosis.
Voenno-medicinskij žurnal. 2017;338(8):74-75
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The detection of viral hepatitis B markers in blood donors in military units

Semenenko T.A., Akimkin V.G., Onufrievich A.D., Volotskaya V.I., Skvortsov S.V., Yarosh L.V., Nikolaeva O.G.


The article presents the results of testing of blood donors in military units for the presence of markers of HBV-infection and assess the prevalence of occult forms. 746 serum samples obtained from blood donors during the period 2013-2015 were tested. The proportion of those rejected from the donation due to detection of HBsAg, were 0,54%, which corresponds to the average Russian indicators. The following hepatitis B markers among HBsAg- negative blood donors were identified: anti-HBc + anti-HBs at 7,6%; «isolated» anti-HBc - in 6,3% of cases. The presence of HBV DNA in the absence of HBsAg was determined to be 0,26% cases, which may indicate occult form of infection. The obtained data confirm the necessity of implementation of molecular biological methods for blood service to improve the level of infectious safety in the use of donors’ blood components.
Voenno-medicinskij žurnal. 2017;338(8):76-77
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«Military Medical Journal» and the Pushkin era

Poddubny M.V.


The subject of the article are the first one and a half decades of the history of the Military Medical Journal, which took place in the so-called «Pushkin era» in the history of the Russian culture. Listed publications, stories, as well as the names of doctors who are related to the poet and his work. The conclusion is confirmed that the «Military Medical Journal» is inscribed in the context of the national culture with not only the names of famous physicians and their achievements. The initial period of the journal’s publication coincided with the «golden age» of Russian poetry and its pages forever retain for the descendants the reflected light of the Pushkin era.
Voenno-medicinskij žurnal. 2017;338(8):78-85
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Voenno-medicinskij žurnal. 2017;338(8):87-90
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Voenno-medicinskij žurnal. 2017;338(8):90-91
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Meeting of the chief phthisiatricians, chief state sanitary doctors, chief radiologists and chief therapists of military districts (fleets) of the Armed Forces

Beznosik R.V., Savitskii G.G., Grishin V.K.


The report on the meeting of the chief phthisiatricians, chief state sanitary doctors, chief radiologists and chief therapists of military districts (fleets) of the Armed Forces of the Russian Federation, which was held on April 10-12, 2017 in Pushkino, Moscow Region, was presented. The purpose of the meeting was to analyze the anti-tuberculosis work in the Armed Forces and methods for improving its preventive focus, discussing the possibility of improving the recording of tuberculosis incidence in the Armed Forces and reporting documentation, identifying a set of measures for the prevention and timely detection of persons with TB and HIV in the Armed Forces.
Voenno-medicinskij žurnal. 2017;338(8):92-96
pages 92-96 views

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