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Vol 338, No 10 (2017)


Medical and statistical characteristics of morbidity of military servicemen at the Armed Forces (2007-2016)

Grigorev S.G., Evdokimov V.I., Ivanov V.V., Sivashchenko P.P., Fefelov D.I.


The results of the analysis of health indicators of military servicemen who are on military service for the period of 2007-2016 are presented. Obtained from reports on the health of personnel and the activities of the medical service (form 3/MED). The average levels were as follows: total morbidity - 1873‰, primary morbidity - 1005%, need for dispensary observation - 118‰, general hospitalization - 997‰‰ (including inpatient treatment in infirmaries - 419‰, hospitals - 567‰, days Labor losses - 10752‰, layoffs for health reasons - 16,7‰, deaths - 33,1 per 100 thousand people. The growth of indicators of general and primary morbidity, hospitalization and decline in lay-offs and death rates were noted. In the structure of the generalized indicator of health disorders, 87% were respiratory diseases; injuries, poisoning and some other consequences of external causes; mental and behavioral disorders; diseases of the skin and subcutaneous tissue; diseases of the digestive system; some infectious and parasitic diseases; diseases of the circulatory system. Prevention of the pathology of these classes will contribute to improving the health of conscript servicemen.
Voenno-medicinskij žurnal. 2017;338(10):4-14
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On disadvantages of medical and expert opinions on the category of eligibility of citizens subject to conscription for military service

Pinchuk P.V., Burmistrova N.V., Chaplyuk A.L., Datsko A.V.


The article presents the results of commission forensic medical examinations and studies conducted in 2016-2017. On instructions from military law enforcement agencies with a view to establishing the justification for making judgments to citizens during the draft campaigns on the category of fitness for military service for health reasons. As a result, it was possible to confirm the conclusion on the category of fitness for military service in only 45,5%. 53% of conscripts did not have the opportunity to express an opinion on the suitability category, either it was not possible or an expert opinion was issued on its change - from limited to military service at suitable for military service with insignificant restrictions. In 1,5% of cases, the experts «weighted» the issued opinion on the category of validity - from limited to the military service at not suitable for military service. The main reasons why the experts did not confirm the conclusions on the category of fitness for military service issued to recruits in military commissariats were established. The ways of eliminating the shortcomings in the work of conscription commissions of municipalities, military commissariats and medical organizations of the public health system are suggested.
Voenno-medicinskij žurnal. 2017;338(10):14-18
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Implementation of the concept of teaching «Emergency medicine» at the training center of the I.M.Sechenov First Moscow State Medical University

Chizh I.M., Rusanov S.N., Putilo V.M.


In the article directions of perfection of teaching of bases of medicine of extreme situations within the section of the discipline «Safety of vital activity. Emergency Medicine» in the military training center at the I.M.Sechenov First Moscow State Medical University, including the methodological aspects of teaching. The concept of teaching the discipline «Medicine of emergency situations» for students mastering the military training program in the military specialty «Medical treatment in ground troops» as a possible generalizing model for all military centers of medical schools in Russia. Its implementation is carried out in two consecutive and complementary training modules: emergency medicine (organizational framework) - implemented at the Department of Life Safety and Disaster Medicine and at a military training center; medicine of emergencies (clinical aspects) - implemented at the Department of Traumatology, Orthopedics and Catastrophe Surgery. The final certification provides for a structured examination: the examiners of the Departments (Life Safety and Catastrophe Medicine, Traumatology, Orthopedics and Catastrophe Surgery) and the teaching staff of the Military Training Center assess the students’ practical readiness and theoretical knowledge jointly.
Voenno-medicinskij žurnal. 2017;338(10):19-23
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Prophylaxis and treatment of ischemic endotoxicosis in case of crush syndrome

Popov A.S., Rybnikov V.Y., Bairamov S.A., Berkutov D.S., Yakirevich S.A.


The clinical experience of complex treatment of victims with the syndrome of prolonged compression during extraction and in the airborne hospital of the Ministry of Emergency Situations of Russia with the use of domestic nanotechnologies - an unparalleled membrane plasmapheresis during the liquidation of medical consequences of earthquakes (Indonesia, Pakistan, 2005; China, 2008; Haiti, 2010). The prevention of ischemic toxicosis it is necessary to conduct directly when extracting the injured from the obstruction by physicians anesthesiologists-resuscitators and surgeons from the search and rescue units. Consistently continue it at all stages of medical evacuation, during an air medical evacuation to the moment of admission to a specialized hospital. The method of detoxification and the volume of medical care provided when extracting the victim significantly influenced the results of treatment outcomes in the airborne hospital of the victims. The use in the first hours of an unparalleled membrane plasmapheresis in the complex therapy of crush syndrome allows reducing the development of severe forms of endotoxicosis, to provide quality training for the victims to medical evacuation, to prevent the development of acute renal failure, and to improve the prognosis of survivorship.
Voenno-medicinskij žurnal. 2017;338(10):24-30
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Oxymortia in young military personnel and cadets: causes, constitutional and clinical risk factors

Pigolkin Y.I., Shilova M.A., Zakharov S.N.


Were studied 24 cases of sudden death of young military personnel and military cadets. The main cause of sudden death in the performance of military service is a sudden cardiac death from the pathology of the heart and blood vessels, not diagnosed during life or proceeding concealed. The manifestation of this pathology is promoted by a sharp change in the habitual way of life with high physical loads and the development of life-threatening conditions-fatal arrhythmias and the onset of sudden death. Connective tissue dysplasia, as a genetically determined pathology with predominant involvement of the heart and vessels, is the main pathology that creates a high risk of sudden cardiac death. Comparison of clinical signs, constitutional manifestations, as well as functional changes in the heart and blood vessels at the clinical level will allow preventing the development of life-threatening conditions and the onset of sudden death among young military personnel.
Voenno-medicinskij žurnal. 2017;338(10):30-36
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Surgical prophylaxis of posttraumatic ankle arthritis of II and I stages in patients after fractures of ankles

Kryukov E.V., Brizhan L.K., Davydov D.V., Yurmina N.S., Kerimov A.A., Slivkov K.A., Sheyanova E.Y.


In the structure of injuries among military personnel admitted to medical institutions, injuries to the musculoskeletal system are 46,7%, ankle injury - up to 20% of cases from their number. In 60% of patients, after ankle fracture, ankle arthritis disease develops, which in most cases leads to disability or a change in the category of fitness for military service. The optimal method, which allows minimally invasive and high-efficiency treatment of patients with ankle arthritis of I-II stage, in whose anamnesis there is a fracture of the ankles, is the treatment and diagnostic arthroscopy of the ankle joint. This method allows the majority of military personnel to return to service without changing the category of fitness for military service and improve the quality of life, which is confirmed by the AOFAS (Kitaoka H.): the rate of excellent results are 47,1% higher, and unsatisfactory results are 23,5% less compared with those who received only conservative treatment.
Voenno-medicinskij žurnal. 2017;338(10):37-42
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Sexual rehabilitation of patients after nerve-sparing radical prostatectomy.

Esipov A.V., Kochetov A.G., Ivanov A.O., Gvasaliya B.R., Kostin A.A., Shidlovskii I.P., Karabach I.V., Ponomarev V.K., Esipov A.S.


The study included 68 patients who underwent nerve-sparing radical prostatectomy for localized prostate cancer and who had normal preoperative parameters of erectile function. Patients were divided into 2 groups, one of which was administered Tadalafil daily in a dose of 5 mg, the other group took a placebo. The results were assessed using the IIEF, EPIC, QoL questionnaires. For an objective analysis of pathophysiological changes, electroneuromyography was used. The early daily use of 5 mg Tadalafil (Cialis) in the postoperative period in patients undergoing nerve-sparing radical prostatectomy, contributes to the restoration of sexual function by improving the erection and maintaining the size of the penis. This circumstance, together with a simultaneous positive effect on the restoration of urinary retention, significantly improves the quality of life in this group of patients
Voenno-medicinskij žurnal. 2017;338(10):42-48
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Surgical treatment and medical rehabilitation of patients with lower extremity varicose vein disease with the application of innovative technologies

Yudin V.E., Dudarev V.V., Yaroshenko V.P., Shchegolkov A.M., Gurev G.S.


This article describes the possibilities of radiofrequency ablation of superficial and perforator veins for patients with chronic venous insufficiency and management of the venous ulcers with air-plasma currents of nitric monooxide. Were performed 113 operations of radiofrequency ablation of incompetent superficial and perforating veins, including 22 operations of radiofrequency ablation of incompetent perforating veins. Were compared SEPS operations and operations of radiofrequency ablation of perforating veins in patients with post phlebothrombosis ulcers (C6 СЕАР). The effects of air-plasma currents of nitric monoxide in the venous ulcers treatment in 29 patients were studied. The relevance and effectiveness of the operations of radiofrequency ablation and the nitric monoxide ulcers treatment were shown.
Voenno-medicinskij žurnal. 2017;338(10):49-55
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Voenno-medicinskij žurnal. 2017;338(10):55-55
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Experience of the use of non-specific preventive means for acute respiratory diseases in military units of the Southern military district

Papko S.V., Goncharov G.V., Lantsov E.V., Ezdin E.B., Zarin A.A., Zabludova V.S.


Authors work in the epidemic period, the incidence of respiratory diseases, including acute respiratory infections in 2014-2015, and during the formation of new military groups. The work was carried out using the method of simple comparative controlled epidemiological experiment in two stages: 1st - study the effectiveness of various means of preventing non-specific (drugs «Kagocel» and «Human Immunoglobulin normal»); 2nd - the study of the effectiveness of the combined use of various means of preventing non-specific (against application of the preparation «Normal Human Immunoglobulin», other drugs were used: «Kagocel» and «Ingavirin»). The purpose of practical work was to study the effectiveness of the means of non-specific prevention of influenza and other acute respiratory infections, either alone or in combination with each other. The study found that a single application of funds used in the experiment of non-specific prevention of influenza and other acute respiratory infections effectively, while their combined use is not advisable, due to the lack of expected additive effect.
Voenno-medicinskij žurnal. 2017;338(10):56-61
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Regulatory aspects of discarding and disposal of expired medications

Levchenko V.N., Lemeshko A.L., Roenko A.S.


The article deals with the problem of the environmentally safe destruction of poor-quality medicines. Its importance is determined by the fact that their share in the total volume of medical waste is about а half. It was stressed that collection and disposal of these funds should be carried out in accordance with the legislation on waste management. Destruction of poor-quality, falsified and counterfeit medicines is carried out by a licensed organization in specially equipped areas or premises in compliance with the requirements for environmental protection. The main reasons for the appearance of inadequate medicines in military medical organizations are analyzed. The order of their collection and transfer to destruction, documenting this process is considered. The analysis of the normative documentation defining requirements to collection, storage and destruction of poor-quality medicines is carried out. Some of the gaps are identified in their provisions, and ways for their elimination are outlined.
Voenno-medicinskij žurnal. 2017;338(10):62-67
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Voenno-medicinskij žurnal. 2017;338(10):67-67
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Case of myocardial infarction due to primary lesions of atherosclerotic plaque in young men

Cherkashin D.V., Svistov A.S., Shakhnovich P.G., Tvorun O.P., Makiev R.G., Zakharova I.M., Tkachenko K.N., Orlov I.L., Gustainis K.R.


Presented by the clinical observation of a young patient with an acute myocardial infarction at the age of 18 years. In a retrospective evaluation of the likelihood of the risk of cardiovascular disease by currently known scales in patients defined low risk. At the same time disease is characterized by severe recurrent course against the background of complex therapy. The authors covered issues of diagnostics, conservative and surgical treatment of acute myocardial infarction.
Voenno-medicinskij žurnal. 2017;338(10):69-72
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Manual technologies in the treatment of bile duct dysfunction in reserve officers

Matvienko V.V., Frolkov V.K., Pankov O.A., Zhernov V.A., Zubarkina M.M.


The effectiveness of osteopathic treatment in patients with chronic acalculous cholecystitis was assessed. The study was conducted in two groups of reserve soldiers (each group consisted of 54 people). A trial group on the background of the classical treatment regimen received osteopathic treatment instead of massage. The parameters of blood, bile, pathobiomechanical disorders in the spine, micro- and macro-mobility of the organs of the subdiaphragmatic space were compared. Statistical analysis of the obtained data was carried out using the Student’s and Pearson’s c2 criteria on the Statistica software package v. 7.0 (Statsoft).
Voenno-medicinskij žurnal. 2017;338(10):72-75
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Mitral valve prolapse as a risk factor for the development of menacing cardiac rhythm disturbances

Ovchinnikov Y.V., Gadzhieva L.R., Palchenkova M.V., Muracheva N.V., Novozhenov V.G., Tkachenko S.B.


Based on the examination of 121 patients with mitral valve prolapse, the analysis of heart rhythm disturbances was performed depending on the severity of the structural changes in the valves of the valvular apparatus. Performed transthoracic and transesophageal echocardiography, 24-hour Holter ECG monitoring. In patients with myxomatous degeneration of the mitral valve flaps, the frequency of recorded rhythm disturbances (including ventricular arrhythmias) markedly prevailed compared with patients with non-classical mitral valve prolapse.
Voenno-medicinskij žurnal. 2017;338(10):75-78
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Voenno-medicinskij žurnal. 2017;338(10):78-78
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Medical service of the 12th Main Directorate of the Ministry of defense of the Russian Federation: from the origins to development prospects

Zemlyannikov D.A., Lamozhanov M.L.


The US monopoly possession of nuclear weapons and the results of its use against Japan at the end of the Second World War gave rise to the desire of politicians of the Western world to use it against the USSR. It became clear that in the conditions of the «cold war» this, eventually, could happen. The USSR leadership took measures to create a reliable nuclear shield and establish the 12th Main Directorate of the Ministry of Defense of the Russian Federation. From the day of foundation of the 12th Main Directorate, one of the main directions of its activities are measures to maintain high professional efficiency and preserve the health of personnel, as well as to protect personnel from the damaging factors of ionizing radiation.
Voenno-medicinskij žurnal. 2017;338(10):79-84
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Branch N 1 of the Burdenko Main Military Clinical Hospital celebrates the 75th anniversary

Lim V.S., Ovinnikov A.A., Efimenko N.A., Nagovitsyn A.V., Gorbachev O.Y., Sapegin A.N.


The article presents the history of the formation, development and current condition of the Branch N 1 (the 7th Central Military Clinical Aviation Hospital) of the Burdenko Main Military Clinical Hospital of the Ministry of Defense of the Russian Federation. At present, the hospital is the leading specialized aviation medical-expert institution of the Ministry of Defense.
Voenno-medicinskij žurnal. 2017;338(10):84-88
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Ofitsial'nyy otdel

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Voenno-medicinskij žurnal. 2017;338(10):89-90
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Voenno-medicinskij žurnal. 2017;338(10):91-93
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Research studies on medical support of military personnel in case of nuclear emergency

Sushilnikov S.I., Lamozhanov M.L., Zemlyannikov D.A., Basharin V.A., Karamullin M.A., Grabskii Y.V., Drachev I.S.


Тhe article presents the main results of the research of special tactical exercises conducted to assess the effectiveness of medical and medico-psychological support of personnel taking part in liquidation of consequences of nuclear materials. We consider the completeness and quality of working out the planning and implementation of health care questions the use of the personnel and advanced medical devices radiation protection of personnel involved in the accident and called to its liquidation. The necessity of improving the organization of the supply of emergency rescue teams specialized medical supplies, upgrade the clinical database to provide specialized, including high-tech, medical aid to the victims with acute radiation damage, recreating on clinical aspects of health care delivery system for training specialists in acute radiation injury.
Voenno-medicinskij žurnal. 2017;338(10):94-96
pages 94-96 views

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