Vol 331, No 10 (2010)

E.I.Smirnov’s views of the role and place of organizational aspects of the greatest Russian surgeon N.I.Pirogov in development of modern medical supply system are covered on the basis of vast historiographical data. From the perspectives of historism and objectivism a degree of realization Pirogov’s ideas during creation of the consistent military-medicine doctrine and organization of medical-evacuational measures during the Great Patriotic War 1941-1945 is analyzed.

Results of 35-years clinical investigation on acute coronary syndrome performed in the 3rd Central military clinical hospital named after A.A. Vishnevsky are presented. Research topics are the following: pathways of blood coagulation alterations,lipid metabolism, improving drug management of ischemic heart disease exacerbations, new medical technologies in diagnostics and treatment of acute coronary syndrome. Decision procedure in patient with acute coronary syndrome was developed in the Hospital. Criteria for percutaneous coronary interventions and coronary artery bypass surgery were elaborated. Original scale for death and cardiac complications risk assessment in patients with acute myocardial infarction undergoing coronary artery stenting was developed. According to the scale, differential scheme of antiplatelet therapy was introduced, and its implementation resulted in decrease of complications rate. Advantage of early invasive strategy vs. conservative approach was proven.

The perioral dermatitis is a multifactorial disease of a face skin meeting in population with frequency of 5% also represents inflammatory process with the various morphological characteristic of an eruption. A total of 511 patients are surveyed by a perioral dermatitis. For the first time clinico-pathogenetic types of development and a disease current (it is hormonal - immunologic, allergic, gastroenterology, metabolic) with characteristic distinctive changes of the hormonal status, a metabolism and immunity system are allocated. The complex of laboratory criteria of diagnostics of the specified types of the perioral dermatitis, giving representation about mechanisms of formation, clinical features of the dermatosis is developed, allowing differentiate to prove the approach to treatment.

The authors consider the problem of objectivity of initial diacrisis of disorder of trophological status as in case of manning and troops of Northern Fleet and also in the interest of military physician expertise at determining of fitness for service. In terms of retrospective analysis of assessment’s results of food status of recruits, submariners and divers in accordance with Government decree N 123 the authors quarreler ranges of denotation of body mass index which are adjusted in this document referring to their own researches. Their research let to get a new denotation of body mass index: «nutritional inadequacy» - <16,59, «suralimentation» - 16,60-19,17, normal balance of growth and weight - 19,18-24,31.

The article is devoted to biographies of the first head of the Department of Anatomy and Physiology of Petersburg Medical-Surgical Academy Professor Nikon Karpovich Karpinsky (1745-1810). Karpinsky contributed to the development of domestic medicine, especially surgery. His first work «The course of surgical dressings» proved it (1776). Multi-faceted medical services Karpinsky successfully combined with various administrative assignments. In 1791 he was appointed as a member of the Medical Board - the highest government body, ruled the Russian medicine, and after its closure in 1804 - the chief scientist of the expedition department in the state medical council and a member of the Medical Council. The apotheosis of his administrative career began in 1805 post-general headquarters, a doctor, who commanded all military medicine of the country.