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Vol 334, No 9 (2013)


Methods of substance abuse prevention in the Armed Forces

Fisun A.Y., Shamrey V.K., Marchenko A.A., Sinenchenko A.G., Pastushenkov A.V.


Dynamics of substance abuse morbidity in the Armed Forces of the Russian Federation during the last 10 years (2002—2012) was analyzed. Results of performed analysis showed decreasing tendency since 2007 in conscripts (0,07% in 2012) and in contract soldiers (0,3% in 2012). Alcoholism prevailed in the structure of substance abuse in conscripts (0,05%), drug abuses were diagnosed 2,5 times less often (0,02%). In contract soldiers non-alcohol abuses were diagnosed in 0,004% of cases. It is stated that the major aims of substance abuse prevention are qualitative recruiting of military units (especially in troops maintaining the combat readiness) and departments (subunits) of military education, creating conditions for propaganda for healthy lifestyle, prohibition of drugs and psychopharmaceuticals in military units. For early detection of persons liable to substance abuse and facts of drug consumption it is necessary to perform a medical examination with the help of special program apparatus complex (such as «Addict») and take into account clinical signs of addiction. Besides, it is necessary to introduce planned and unexpected medical examinations of servicemen. Algorithm of measures in case of detection of serviceman with alcohol or drug intoxication is given. In conclusion the main organizational principals of substance abuse prevention in the Armed Forces are given.
Voenno-medicinskij žurnal. 2013;334(9):4-10
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Clinical and epidemiologic monitoring of polytrauma and concomitant injuries

Lutov V.V., Bulatov M.R., Sushchenin A.A., Makhnovskiy A.I.


Current forms of medical reports cannot be used for clinical and epidemiological and medical and economic researches because they don’t contain information about competitive, associated diseases and its complications. Authors developed the method of clinical and epidemiological monitoring of nosologic structure of patients in military-medical institutions based on personalized record-keeping of patients with additional informational resources for recording of all diagnoses and performed medical service. With the help of the given method were analyzed nosologic structure and treatment results of 548 patients with vehicular trauma from the 442 nd District Military Clinical Hospital. Polytrauma was revealed in 22% of patients, concomitant injury — in 39%, combined injures — in 0,4%. Besides, in 8% of patients were revealed associated chronic diseases that not only confound trauma, but also make difficult to diagnose and assess the severity of trauma.
Voenno-medicinskij žurnal. 2013;334(9):11-13
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Optimization of educational activity of departments of educational creativity in the Extension Course Institute for Medical Practitioners MUNKTs n. a. P.V.Mandryka

Balakhovskiy A.A., Koshelev V.P., Anufriyev A.A., Vlasenko T.N.


Educational creativity is the key component of educational activity. The article is devoted to logical structure of educational creativity, difficulties and problems of formation and development of educational creativity in lecturers participating in educative process with participants of the Extension Course Institute for Medical Practitioners MUNKTs n. a. P.V.Mandryka. Heuristic activity and methods that are a huge part of educational creativity are emphasized. Specific features of heuristic activity are shown; classification of heuristic methods is presented. For the first time authors gave characteristic of qualitative levels of educational creativity.
Voenno-medicinskij žurnal. 2013;334(9):14-22
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Acute allergy in practice of military physician

Khalimov Y.S., Vologzhanin D.A., Mitin Y.A., Lobkova O.S., Bala A.M.


Increasing number of patients with allergy observed in recent years is accompanied with increasing number of health encounters due to acute allergy. The sudden beginning and unpredictable course characterize acute allergy. These factors can be fatal for patient and must be treated immediately. Allergic rhinitis, allergic conjunctivitis, acute urticaria, angioedema and anaphylaxis refer to diseases based on acute allergy. The most dangerous diseases, characterized by fatal conditions, are generalised urticaria, angioedema and anaphylaxis. Knowledge of first aid principles is the most important factor of effective treatment because quickness of allergy progression requires prompt decisions. Use of the whole complex of modern therapeutic possibilities is the most important and durable. Modern methods of first aid for acute allergy, based on recommendations from foreign and domestic publications, are given in the article.
Voenno-medicinskij žurnal. 2013;334(9):23-28
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Early diagnosis of dementia with the help of MR-morphometry in patients with Parkinson’s disease

Trufanov A.G., Odinak M.M., Litvinenko I.V., Rezvantsev M.V., Voronkov L.V.


54 patients with idiopathic Parkinson’s disease were examined. 1,5 Tesla MRI with T1 gradient-echoprotocol and following calculating by FreeSurfer software was performed. Dementia was revealed in 23 patients. Significant changes of different zones of brain-cortex were revealed in patients with Parkinson’s disease accompanied by dementia. Changes were revealed in the hemispheres, particularly in frontal, temporal and occipital lobes. Thickness of lingual medial occipitotemporal gyrus can be used as a criterion for dementia prognosis. Individual patient monitoring and cortex alteration evaluation allow prognosticating increasing risk of cognitive disorders development and prescribing proper therapy.
Voenno-medicinskij žurnal. 2013;334(9):29-34
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Treatment of rupture of abdominal aortic aneurism in multi-field military hospital

Belyakin S.A., Obraztsov A.V., Pinchuk O.V., Kryzhov S.N., Yamenskov V.V., Bokachev R.A., Tikhonov P.A.


For the last 5 years in the center of vascular surgery of Vishnevskiy 3rd Central Military Clinical Hospital 218 patients with abdominal aortic aneurism were treated, 96 planned surgical operations for abdominal aortic aneurism (post-operative mortality 3,1%) were performed. 11 patients underwent urgent surgical operation because of rupture of abdominal aortic aneurism. 1 of 11 patients died at the stage of laparotomy, the second patient died after clipping of ruptured aneurysm. In other 9 cases surgical operation was performed successfully. But 2 of 9 patients died in a few hours after surgery. In summary, 4 of 11 patients underwent surgical operation for rupture of abdominal aortic aneurism survived. The postoperative mortality was 63,6%. Authors gave an example of successful treatment of patient with rupture of abdominal aortic aneurism. It was concluded that successful treatment of rupture of abdominal aortic aneurism is possible only in case of well-run integration of different treatment and diagnostic departments. CT angiography is crucial for instrumental diagnostics of rupture of abdominal aortic aneurism. Successful surgical operation is impossible without organized blood supply service, refusion and donor blood. Artificial lung ventilation, extracorporal detoxication and adequate pharmacological supply help to avoid severe complications during the postoperative period, even in patients with associated pathology.
Voenno-medicinskij žurnal. 2013;334(9):35-38
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Low-intensity impulse supra-sonic stimulation of osteogenesis for bone fractures and nearthrosis in ambulance situation

Saks L.A.


The author tried to draw attention of orthopaedic traumatologists to effective innovative technology — low-intensity impulse suprasonic stimulation of osteogenesis for fractures of bones and nearthrosis not only in outpatient, but also in in-patient departments. Mechanisms of the given methodic are described. It is showed that after the treatment fracture union signs that can be diagnosed by radiology are registered: from mild periosteal union to the signs of central callus formation and its remodeling. Amount of sessions in case of delayed hip fracture union (osteosynthesis) — 50; delayed crus fracture union and nearthrosis — from 40 to 45 sessions; shoulder nearthrosis — 40 sessions. The author came to conclusion that it is necessary to study mechanisms of osteogenesis and homeostasis of other tissues. That will help to change treatment programme for patients with musculoskeletal disorders and traumas, for functional recovery and improvement of quality of life.
Voenno-medicinskij žurnal. 2013;334(9):39-45
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Hypertensive heart disease and noninsulin-dependent diabetes mellitus: modern strategies in antihypertensive therapy

Barsukov A.V., Talantseva M.S.


Hypertension (HTN) and noninsulin-dependent diabetes mellitus (NIDDM) are two non-communicable pandemic of the late 20th century and early 21st century. Despite the active prophylaxis measures performed by the State, there is a tendency to increase of HTN in Russia. Incidence rate of hypertension is depending of age and increases in patients of elderly age (80%). According to the International Diabetes Federation, 10% of people in Russia suffer NIDDM of different genesis. The authors covered the topical issues of modern strategies in antihypertensive therapy in patients with NIDDM and HTN according to large randomized trials. The authors analyzed the possibilities of conventional and modern therapies of hypertension, organoprotection, metabolic neutrality and impact on prognosis in patients with NIDDM. It is underlined that the renin-angiotensin-aldosterone system is a part of the cardiovascular continuum and links various risk factors, like end-stage of cardiovascular disease and chronic renal disease. Monitoring of arterial blood pressure is crucial for patients with essential hypertension and NIDDM. Pharmacological blockade of the renin-angiotensin-aldosterone system is the most desirable method of treatment of hypertension and noninsulin-dependent diabetes mellitus. This method reduces the risk of cardiovascular complications.
Voenno-medicinskij žurnal. 2013;334(9):46-53
pages 46-53 views

Clinicopathologic and endoscopic characteristics of chronic gastritis in flight personnel

Chernekhovskaya N.E., Shcherbakov P.L., Bygayeva M.Y.


Surveyed 119 men in flight personnel. All were performed esophagogastroduodenoscopy and morphological study of biopsy material. Level of specific antibodies to Helicobacter pylorus (Hp) by enzyme immunoassay was determined, performed breathing Helika-test; Hp was determined by cytological method. Performed acidogastrometry. In 8 patients revealed erosive antral gastritis, 99 — chronic gastritis, 12 patients have no stomach or duodenal ulcers. All patients with erosive gastritis were infected with Hp. antibodies to Hp were detected in all patients with chronic gastritis, and Helika-test and cytology for Hp were negative in 18,2% of patients in this group.
Voenno-medicinskij žurnal. 2013;334(9):54-58
pages 54-58 views

Health status of female soldiers serving in the Northern Fleet

Myznikov I.L., Askerko N.V., Ustimenko L.I., Miloshevskiy A.V., Khankevich Y.R., Volkova L.V., Sadchenko S.N., Matochkina A.A.


Authors analyzed the health status and morbidity among female soldiers serving under the contract in the Northern Fleet, age peculiarities, results of medical in-patient examination and expert assessment, put in medical records in accordance with prophylactic medical examination service and medical examination. Annual data about military troops, morbidity and medical examination among female soldiers in the period 2002—2010 (n~14,5 thousand of people) are included into analysis. 502 medical records of female soldiers approved by military physician board were analyzed. Authors presented statistic data about primary diseases and chronic pathology and considered causes of changing of the category of fitness for military service and its gender peculiarities. Authors suggest changing the recruiting concept for female soldiers and the system of medical in-patient examination.
Voenno-medicinskij žurnal. 2013;334(9):59-64
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Brief reports

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Voenno-medicinskij žurnal. 2013;334(9):65-75
pages 65-75 views

From the history of military-medical examination in the Far East (To the 60th anniversary of the 4th Branch of the Main center of military-medical examination of the Ministry of Defense of RF)

Pashkovskiy R.D.


Military-medical examination is a part of medical service of the Armed Forces of the Russian Federation and plays a significant role in recruiting military troops with healthy, physically vigorous soldiers, in saving and improving of health of military personnel, in undertaking prophylaxis and therapeutic measures, in solving social problems of servicemen and their families. Military-medical examination board of Eastern Command plays a significant role in the system of military-medical examination of the Armed Forces of the Russian Federation. The article is devoted to the history of formation and development of military-medical examination in the Far East depending on aims and goals of military-medical service at different stages of military formation. Eastern Command dated back to the Civil War, has changed its organization, boundaries, structure and name many times. According these changes many new military-medical departments, including military-medical examination board, were reorganized, disbanded and created. Various military-medical commissions alternating or working simultaneously at different military units were created in the Far East.
Voenno-medicinskij žurnal. 2013;334(9):76-79
pages 76-79 views

Nonsurgical therapy of wounds during the Great Patriotic War (Following «Gospitalnoe delo» magazine)

Petrov M.M.


The article investigates reasons of increase of labour-saving innovations and inventions made by physicians during the great patriotic war. It is proved that suggestions made during the analyzed period (1942) showed no much novelty and originality. From the article it follows that soviet physicians at the beginning of the Great Patriotic War had no proper knowledge about military surgery.
Voenno-medicinskij žurnal. 2013;334(9):80-85
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Official communications

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Voenno-medicinskij žurnal. 2013;334(9):86-88
pages 86-88 views

News feed

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Voenno-medicinskij žurnal. 2013;334(9):85-92
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