Vol 338, No 9 (2017)


Deviant behavior predication among conscripts

Kuvshinov K.E., Shamrei V.K., Chaplyuk A.L., Dnov K.V., Marchenko A.A., Baurova N.N., Seregin D.A., Brovkin S.G., Datsko A.V.


The article substantiates the identification of five types of deviant behavior that are topical for servicemen («avoiding», «suicidal», «aggressive», «delinquent», «addictive»). It is shown that the currently used methods of predicting deviant behavior are not perfect: the share of military personnel who showed signs of deviant behavior in prospective observation (14,3%) was significantly higher than the number of people sent for repeated medical examination by psychiatrists in Within the framework of conscription campaigns in connection with suspected addiction to deviant behavior (0,96%). The developed technique for diagnosing susceptibility to deviant behavior («ISADA») is given. Recommendations are given on its use in the Armed Forces.
Voenno-medicinskij žurnal. 2017;338(9):4-11
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Experience of medical support organization at the III winter International military games

Yakovlev S.V., Melchakov A.A., Nefedov K.V.


Authors describe participation of the medical service of the Armed Forces and other structures in organization of medical support at the III winter International military games, which took place in Sochi on 22-28 February 2017. The main purpose of medical support was to provide highly qualified medical aid to sportsmen, members of official delegations, judges, members of the media, and spectators. Primary objective was to deliver emergency aid to sportsmen at the competition places and prompt evacuation to specialized medical institutions. It is underlined that medical support of games was fully organized, and the medical service met the challenges.
Voenno-medicinskij žurnal. 2017;338(9):11-14
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Temporary endovascular arterial shunting - a new solution for treatment of severe vascular injury

Reva V.A., Yudin A.B., Denisov A.V., Telitskii S.Y., Semenov E.A., Zheleznyak I.S., Mikhailovskaya E.M., Samokhvalov I.M.


We completed experiments for assessment of the possibility of implementation of our conception of the temporary intravascular shunting (TIS) on a new laparoscopic model of acute occlusive thrombosis of the external iliac artery (EIA). After making thrombosis of the 3-cm portion of the left EIA of two sheep we performed recanalization of a zone of injury by a guide wire followed by a nitinol 7 mm х 5 cm polyurethane covered stent-graft implantation, what took approximately 60 minutes. Animals were followed for 30 days. Anticoagulants and antiplatelet drugs were not administered. Control ultrasound examinations and computed tomography showed that one stent remained patent and another stent thrombosed by postoperative day 3 that did not contribute to limb function. Thus, a proposed method of TIS allows temporarily restoring of blood flow in an injured artery, and might become one of the means of treatment of severely injured patients with major arterial injuries.
Voenno-medicinskij žurnal. 2017;338(9):15-19
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Possibilities of a modern antiviral therapy for lymphoproliferative diseases associated with a chronic HCV infection

Chervinko V.I., Ovchinnikov Y.V., Kryukov E.V., Selkova E.P., Semenenko T.A., Zubkin M.L.


The authors present the characteristics of modern antiviral drugs and the assessment of their use in patients with lymphoproliferative disorders associated with chronic HCV infection. The appearance of direct antiviral agents significantly increased the efficacy and safety of treatment of chronic HCV infection. An important advantage of new drugs was the possibility of their use in far-advanced stages of liver and kidney disease, as well as the absence of a risk of exacerbation of autoimmune processes and the activation of the rejection reaction of solid organ transplants. The effect of these drugs is aimed at suppressing important stages of the life cycle of HCV, preventing the formation of new viral particles. Depending on the nature of the targets, several groups of these drugs are isolated. An important feature of the treatment of chronic HCV infection with PPD drugs is the need for their combination, taking into account the impact on different points of the application. In some clinical situations, their effect can be enhanced by the addition of ribavirin.
Voenno-medicinskij žurnal. 2017;338(9):20-25
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Complex treatment of neuroallergodermatosis in military personnel, taking into account psycho-vegetative disorders

Samtsov A.V., Sukharev A.V., Patrushev A.V., Nazarov R.N.


The purpose of the work is to determine the severity, structure and methods of correction of psychosomatic disorders in the complex treatment of neuroallergodermatosis in military personnel. Personality-psychological features and the state of the autonomic nervous system among servicemen suffering from atopic dermatitis and eczema were studied. Diagnosis of psycho-vegetative disorders was carried out based on the results of a comprehensive clinical, psychological and psycho-physiological examination. The spectrum of psychosomatic disorders in neuro-allergic dermatoses was established, the use of psychotropic therapy with the latest generation drugs was justified, and a modern method of psychocorrection-systemic behavioral psychotherapy was used. Based on the results of the survey, a method for diagnosing and correcting psychosomatic disorders in the course of complex treatment of military personnel with atopic dermatitis and eczema was developed. Complex treatment of neuroallergodermatosis in the military with a medical and psychological correction allows an average of 7 days to shorten the period of improvement of clinical indicators, for 14 days - the period of normalization of the psychophysiological state and quality of life of patients.
Voenno-medicinskij žurnal. 2017;338(9):26-33
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Modern problem of early diagnosis of tuberculosis

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


The second century the humankind has been using tuberculin for the Mantoux diagnostic test, which is still the international standard for early diagnosis of tuberculosis in children and adults. However, with the accumulation of observations and their analysis, publications on the complexity of the interpretation of the results of this classical test began to appear more and more often in the medical literature. Domestic scientists created an allergen tuberculosis recombinant, called by authors «diaskintest» and intended to improve the quality of diagnosis of tuberculosis infection. The effect of the drug is based on the detection of a cellular immune response to antigens specific for mycobacterium tuberculosis. Taking into account the peculiarities of the conditions of service and the life activity of military collectives, a huge danger of the emergence of patients with active tuberculosis in this environment, the research work is carried out in the branch to justify the expediency of simultaneous placement of Mantoux samples and allergen by tuberculosis recombinant in conscripted and contracted servicemen on different hands.
Voenno-medicinskij žurnal. 2017;338(9):34-40
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Evaluation of the effectiveness of vaccination against typhoid fever in an endemic region

Ratnikov N.N., Akimkin V.G., Azarov I.I., Kovalenko A.N.


An evaluation of the effectiveness of vaccination against typhoid fever in a military collective at the typhoid endemic territory of the Republic of Tajikistan was carried out. The study included two groups of vaccinated military servicemen and one control group of unvaccinated civilian personnel. The rate of formation and duration of preservation of immunity after vaccination with the drug «Vianvak» was studied. In the blood serum of vaccinated military servicemen, specific antibodies to S.Typhi (Vi-antibodies) were detected: in 0,5-1 month in 65,2±5,56%, in 2-3 months in 74,3±3,09% , in 8-9 and 12-15 months, respectively, in 33,0±5,01% and 27,8±8,17% of the observed. In the serum of civilian personnel not vaccinated against typhoid, Vi-antibodies were detected in 57,8±7,36% of the examined. It is concluded that the intensity of immunity in 3-8 months after vaccination with the drug «Vianvak» does not provide sufficient security for military servicemen against typhoid fever. In the case of 57% of unvaccinated civilian personnel, additional research is required on the bacteriophage S. Typhi.
Voenno-medicinskij žurnal. 2017;338(9):41-46
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Еffectiveness of the use of ultraviolet and photoplazmacatalytical air clarifier in barracks

Zhogolev S.D., Aminev R.M., Zhogolev K.D., Kotov S.S., Gorenchuk A.N., Bolshakov V.S., Protasov R.M., Kharitonov M.A., Zhurkin M.A., Znamenskii A.V., Shipitsyn K.S., Kolesnikov V.V., Zharkov D.A.


Authors assessed ultraviolet air irradiator-recirculators and photoplazmacatalytical anti-bacterial ultraviolet recirculating air clarifiers. It is determined that the use of both types of devices significantly reduces air microbial content in dormitories and reduces acute respiratory disease morbidity by sufficient amount of devices per room (not less than one per 100-200 m3). Photoplazmacatalytical anti-bacterial ultraviolet recirculating air clarifiers are more effective.
Voenno-medicinskij žurnal. 2017;338(9):47-54
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Features of symptomatology, autonomic regulation and central hemodynamics in aircrew with poor tolerance of hypobaric anoxia

Vartbaronov R.A., Churilov Y.K., Shishov A.A., Vovkodav V.S., Bondareva S.V., Shishkin A.N.


The features of unfavorable symptoms, vegetative reactivity, shifts in central hemodynamics and cardiac rhythm disturbances under hypobaric anoxia in a pressure chamber in 126 members of aircrew with poor hypoxia tolerance were investigated. The average age of the examinees was 32,7±7,8 years. The results of the research showed that the most informative signs of achieving the precollaptic hypoxic state were the objective symptoms of external observation (pallor of the facial skin, hyperhidrosis and cyanosis) in combination with electrocardiogram and arterial pressure in the brachial artery (100%), while only 40,5% of the pilots surveyed. Specific features of individual reactions to hypobaric hypoxia in the form of vasovagal, vasodepressor, mixed, hypertonic, hypersympathetic, hyperadrenergic and arrhythmic types have been specified. A certain prognostic significance of the vasodepressor type has been established, advancing for several minutes the development of the first symptoms of the precollaptic hypoxic state. The reliable dependence of the poor tolerance of hypobaric anoxia on the good in the control group of 18 people on the distribution of the types of the initial vegetative tone was not obtained, which indicated the absence of an interrelation between the state of the initial vegetative tonus and the reduced tolerance of hypobaric hypoxia. The revealed features of the symptoms of hypoxic disorders: their predominance in the first 10 minutes of exposure to hypobaric hypoxia, the need to enhance the adaptive effect of the sample, and the rare frequency of registration of objective symptoms (reducing the effectiveness and safety of hypobaric hypoxia) are recommended for inclusion in regulatory documents regulating the procedure of this functional loading test.
Voenno-medicinskij žurnal. 2017;338(9):55-64
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Voenno-medicinskij žurnal. 2017;338(9):64-64
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Modern methods of quality control of medicines in military medicine

Levchenko V.N., Paskar G.V., Stepanova I.V., Zveryachenko A.S., Enikeeva R.A.


Since January 1, 2016, in connection with the introduction of the XIII edition of the State Pharmacopoeia of the Russian Federation, which includes the revised general pharmacopoeial articles that have been introduced for the first time and the quality control methods for medicines, the list of methods and scope of measures for quality control of medicines in the Armed Forces. The characteristic of general pharmacopoeial (229, including 99 introduced for the first time) and pharmacopoeial (179, including 20 introduced for the first time) articles is presented. The possibilities of the Center for Pharmacy and Medical Technology of the Ministry of Defense of Russia on quality control of medicines using all methods of analysis in accordance with the requirements of the State Pharmacopoeia are shown.
Voenno-medicinskij žurnal. 2017;338(9):65-70
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Voenno-medicinskij žurnal. 2017;338(9):70-70
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Comparative assessment of the quality of life of officers of the Armed Forces and military retirees

Popov A.V., Polovinka V.S., Konovalov O.E., Bulatov M.R., Breusov A.V.


The quality of life (according to the method of D. Ware, 8 parameters) was studied for 465 military officers who are in reserve and retired, and its dependence on health was assessed. The highest quality of life indicators were among servicemen who were retired for more than 3 years, the lowest - for servicemen a year before they left the Armed Forces and in the first year after they were dismissed. Correlations between the quality of life and medical and social factors-health status, official (labor) activity, family relationships, material position, quality of medical care, housing and social security, were established.
Voenno-medicinskij žurnal. 2017;338(9):73-74
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Successful thrombolytic therapy in female patient with massive pulmonary embolism in early post-operative period

Ovchinnikov Y.V., Linchak R.M., Zelenov M.V., Palchenkova M.V., Salakheeva E.Y.


Authors give an example of successful thrombolysis in female patient, age 65, with massive pulmonary embolism, advanced in early post-operative period after the planned knee replacement surgery. The accelerated (50 mg during 15 minutes) system thrombolysis with a tissue-type plasminogen activator of alteplase was applied. With the aim to reduce bleeding complication risk, the procedure was performed with the use of bleeding installation for extremities. The main role in saving life of female patient with severe pulmonary embolism, according to authors, played timely diagnosis of the advanced disease and the system thrombolysis despite contraindications.
Voenno-medicinskij žurnal. 2017;338(9):74-76
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Combined therapy as a prophylaxis of postoperative pyoinflammatory complications in urology

Esipov A.V., Kostin A.A., Kochetov A.G., Esipov A.S.


Issues of research studies and development of prevention of pyoinflammatory complications in urology remain acute in 21st century. The choice of the most rational prevention technique allows preventing its development and reducing an amount of bed-days in a hospital in average by 25%. This article presents the application results of the combined technique, which has a positive impact on patients after urogenital surgical procedures.
Voenno-medicinskij žurnal. 2017;338(9):76-78
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Testicular torsion in young men of draft age

Shestaev A.Y., Babkin P.A., Kushnirenko N.P., Kharitonov N.N., Rassvetaev A.V., Iglovikov N.Y., Samatygo A.B., Sivakov A.A., Sergienko A.Y.


Under our supervision in occasion of a torsion of a testicle there were 16 patients of draft age (from 17 till 22 years). In one patient, the torsion of the right testicle was eliminated conservatively by closed chiropractic defection counterclockwise 5 hours after the onset of the disease. In nine patients with a surgical examination of the scrotum organs, 180° torsion, anterior appendage and signs of testicle viability were revealed: after elimination of torsion, the operation was terminated with orchiopexy. Six patients under revision had a 180-360° degree torsion and signs of testicular non-viability, which required orchiectomy. The conclusion is that the diagnosis of torsion of the testicle is difficult for general practitioners, including for the army doctor and the doctor of the «First Aid». Urgent hospitalization of patients in the urological (surgical) department of the military hospital and the earliest possible surgical revision of the scrotum organs allow to diagnose and eliminate the torsion, while preserving the vitality of the affected testicle.
Voenno-medicinskij žurnal. 2017;338(9):78-80
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Vestibular factors of spatial disorientation during aviation flight and methods of flying personnel training

Chistov S.D.


The article presents information on the factors of illusion of attitude during the flight in flying personnel. Formulated methodical approaches to psycho-physiological training of flight crews for spatial orientation.
Voenno-medicinskij žurnal. 2017;338(9):80-82
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Specialized geriatric examination at the Department of anaesthesiology and resuscitation

Ilnitskii A.N., Gorelik S.G., Volkov D.V., Ermolaev V.A., Belov D.F., Kulikov V.A.


The technique of specialized geriatric examination in order to assess the operational and anaesthetic risk, reduce the number of complications in the postoperative period, as well as improve quality of life in elderly patients.
Voenno-medicinskij žurnal. 2017;338(9):82-83
pages 82-83 views

From the history of the Znamensk military hospital

Papko S.V., Musaev R.B., Markov R.A.


Article presents the history of the Znamensk hospital in relation to the history of the missile test range “Kapustin Yar”. The hospital was founded in 1946 at the premises of the Burdenko main military clinical hospital. Today the newest methods of diagnosis and treatment are implemented into everyday work of treatment sections, great attention is paid to critical conditions therapy.
Voenno-medicinskij žurnal. 2017;338(9):84-86
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Voenno-medicinskij žurnal. 2017;338(9):86-86
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Bel'skikh A.N., Solov'ev I.A.
Voenno-medicinskij žurnal. 2017;338(9):87-89
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Voenno-medicinskij žurnal. 2017;338(9):90-92
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International Conference on Disaster and Military Medicine (DiMiMED 2016)

Samokhvalov I.M., Grebenyuk A.N.


Authors present a report on the 4th Conference on Disaster and Military Medicine, which was held in Germany. Scientific program of the conference included the following issues: medical challenges in refugee crisis, infectious diseases, medical evacuation transport, CBRN, mental health, disaster medicine.
Voenno-medicinskij žurnal. 2017;338(9):93-96
pages 93-96 views

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