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Vol 340, No 5 (2019)


Hospital of the management of the Armed Forces of the Russian Federation

Trishkin D.V., Krainyukov P.E.


In May 2019, the 100th anniversary of the P.V.Mandryka Central Military Clinical Hospital, the leading medical institution of the Ministry of Defense of the Russian Federation providing medical care to senior management of the Armed Forces of Russia, is celebrated. The article presents data on the creation, establishment and development of the system of assistance in the hospital in different periods of our country’s history: the Civil War, the first post-war years, the Great Patriotic War, the present. The creation (since 1921) of the care system, including an outpatient unit (polyclinic - dispensary-polyclinic department), hospital (hospital) and rehabilitation stage (hospital sanatorium - rehabilitation clinic), is shown.
Voenno-medicinskij žurnal. 2019;340(5):4-8
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Voenno-medicinskij žurnal. 2019;340(5):8
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Development of surgery at the P.V.Mandryka Central Military Clinical Hospital

Skorobogatov V.M., Satsukevich V.N., Abashin V.G.


The article presents the historical data on the formation and development of the surgical direction in the work of the P.V.Mandryka Central Military Clinical Hospital since its establishment. The structure of the hospital surgical service, the organization and scope of surgical care are presented.
Voenno-medicinskij žurnal. 2019;340(5):9-15
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Heart surgery in the P.V.Mandryka Central Clinical Hospital: establishment, present and future

Sergoventsev A.A., Borisov I.A., Dalinin V.V., Steklov V.I., Dieva T.V.


The history of the establishment of the cardiac surgery service in the P.V.Mandryka Central Clinical Hospital. A twelve-year journey from a cardiac surgery department with one operating room and several resuscitation beds to a cardiovascular surgery center with separate unit specializing in open heart surgery, arrhythmology, X-ray endovascular surgery, its own resuscitation unit and an operating unit. Considered the birth, development, results and achievements.
Voenno-medicinskij žurnal. 2019;340(5):16-20
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Technology of the stroke prevention: experience in the use of methods of preventive cardioneurology

Rudskikh O.P., Shirokov E.A., Batusov O.V., Suvorov A.V.


Summarized twenty years of experience in the P.V.Mandryka Central Military Clinical Hospital stroke prevention system among the assigned contingent. A retrospective non-randomized cohort study was conducted to assess the results of use in a group of patients with a high cardiovascular risk of visualization and functional diagnostics of the circulatory system. The incidence of stroke, its types (ischemic, hemorrhagic), subtypes of ischemic stroke, and hospital mortality were analyzed. Examination of patients included electrocardiography, Holter monitoring, ultrasound duplex scanning of the carotid and vertebral arteries, echocardiography, 24-hour blood pressure monitoring. For the studied period, the use of these methods per 1000 patients increased 1.4-4.1 times, and the incidence of stroke decreased by 28%. In the structure of acute disorders of cerebral circulation, the proportion of cardioembolic strokes increased from 8 to 24%, the number of atherothrombotic strokes decreased from 40 to 12%. It was concluded that modern methods of ultrasound diagnostics and functional studies of the circulatory system under the condition of qualified interpretation of the data obtained significantly increase the effectiveness of preventive programs and reduce the frequency of strokes.
Voenno-medicinskij žurnal. 2019;340(5):20-27
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Surgery of aortic defect in the P.V.Mandryka Central Military Clinical Hospital

Sergoventsev A.A., Borisov I.A., Dalinin V.V., Uimanova M.Y.


Presented the experience of traditional cardiac surgery for aortic defect in 191 patients. In 49.2% of cases, the clinic of aortic stenosis prevailed, with the obstructive function of the valve preserved. Surgeries to patients were performed under conditions of cardiopulmonary by sternotomy access. To replace the defective aortic valve, modern, both mechanical and biological prostheses were used. A significant reduction in the temporal parameters of the operation (up to 64%) was achieved when using the frameless Perseval-S bioprosthesis. Evaluation of the immediate results of the operation was carried out 2-3 months after the patients underwent a rehabilitation course. Subsequently, operated patients (n=180) were examined after 6, 12, 24 months. The classical method of surgical treatment of aortic defect remains a priority and relatively safe. If there is evidence, delay in surgical treatment increases the risk of intervention, and in some cases leads to failure.
Voenno-medicinskij žurnal. 2019;340(5):27-35
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Approach of the transperitoneal laparoscopic hernioplasty with dissection of the hernial sac

Chernykh V.G., Skorobogatov V.M., Efremov K.N., Bondareva N.V.


The most traumatic stage of laparoscopic hernioplasty in oblique inguinal hernia is the discharge of the hernia sac, which, in its implementation, damages the blood and lymphatic vessels of the spermatic cord to varying degrees. Dissection of the hernial sac, leaving a portion of the peritoneum on the tissues of the spermatic cord, reduces the negative effects of the operation. We applied this method in 10 patients in 2016-2018. Complications associated with the spermatic cord damage, in the postoperative period was not.
Voenno-medicinskij žurnal. 2019;340(5):36-39
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Effectiveness of pelvic lymphadenectomy in the treatment of prostate cancer

Shershnev S.P., Reinyuk O.L., Savilov A.V., Levkovskii A.N., Krainyukov P.E., Babskii V.I., Makanin M.A.


The results of extended pelvic lymphadenectomy for radical prostatectomy performed in 157 patients with localized and locally advanced prostate cancer from 2012 to 2017 are analyzed. In addition to the treatment-and-prophylactic effect, lymphadenectomy and prostate cancer determine the need for adjuvant treatment. The frequency of metastases and their localization were assessed, the risk of complications when performing advanced pelvic lymphadenectomy was analyzed. Lymph node metastases were diagnosed in 22 (14%) patients, a total of 42 affected nodes were removed. According to N + localization, 14 (33.3%) were detected along the external iliac vessels, 19 (45.3%) in the internal iliac vessels, and 9 (21.4%) in the locking fossa of the lymph nodes. Thus, metastasis of prostate cancer was most often (45.3%) diagnosed in the internal ileal lymph nodes.
Voenno-medicinskij žurnal. 2019;340(5):39-46
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Comorbidity in various age groups of reserve officers (retired) and their family members

Sergoventsev A.A., Afonaskov O.V., Demyanenko A.V., Mashkov T.N., Popov A.V., Gudantov R.B.


The results of a retrospective analysis of 370 case histories of reserve officers (retired) and their family members in the age groups of 44-60 years (n=58), from 60 to 75 years (n=158) and older than 75 years (n=158) are presented. In the age group older than 75 years, the most frequent pathologies are coronary heart disease, hypertension, dyscirculatory encephalopathy, chronic heart failure, in the groups from 60 to 75 years and 44-60 years, hypertension dominates, and for the remaining pathologies there is a significant decrease in indicators. Combinations of four lesions (cardiovascular, endocrine, urinary and central nervous) and three systems (cardiovascular, central nervous, endocrine) were found only in age groups older than 75 years and from 60 to 75 years. In the age group of 44-60 years, comorbidity makes up 1% of the total index and is represented by pathology of the cardiovascular and central nervous systems.
Voenno-medicinskij žurnal. 2019;340(5):46-50
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Clinical possibilities for the prevention of tolerance disorders when using combination therapy in patients with primary open-angle glaucoma

Kuroedov A.V., Kondrakova I.V., Gorodnichii V.V., Gaponko O.V.


The goal of antihypertensive treatment of glaucoma is to achieve a «target pressure» level. The reason for the gradual decrease in the effectiveness of the action of drugs is directly related to the need for lifelong treatment of patients with glaucoma and is due to a change in tolerance. The results of a prospective study of 22 patients (35 eyes) with different stages of primary open-angle glaucoma, aged 74 (71; 77) years, with an average illness duration of 11 (6; 14) years, receiving combined antihypertensive therapy for 11 (6; 12) month Against the background of the compensated level of intraocular pressure and the planned replacement of one of the previously prescribed drugs, including the recommended washout period, an additional significant decrease in the level of intraocular pressure was achieved.
Voenno-medicinskij žurnal. 2019;340(5):50-58
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Voenno-medicinskij žurnal. 2019;340(5):58
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Room of diagnosis and treatment of pain is a necessary division of the clinical hospital in modern conditions

Krainyukov P.E., Yakovlev A.E., Rudskikh O.P., Suvorov A.V.


In connection with the peculiarities of military service in recent years, an understanding has emerged of the need for early and comprehensive treatment of pain syndrome in military personnel in specialized pain centers using safe and effective minimally invasive techniques. In the established office of diagnostics and treatment of pain, a positive clinical result was achieved in 95% of cases, which confirms the effectiveness of the treatment of pain syndrome, improvement of the functional status and ensures the continuation of active military service.
Voenno-medicinskij žurnal. 2019;340(5):59-61
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On the provision of medical care to patients of the dispensary group in a multidisciplinary military medical organization

Mashkov T.N., Krainyukov P.E.


The data on the creation of a dispensary department in the P.V.Mandryka Central Military Clinical Hospital, tasks to improve the comprehensive examination of the dispensary group, preliminary results of a retrospective study of the dispensary group.
Voenno-medicinskij žurnal. 2019;340(5):61-62
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Modern views on the epidemiology and diagnosis of neuroendocrine tumors.

Simonenko A.V., Krainyukov P.E., Dulin P.A.


Modern approaches to the diagnosis of neuroendocrine tumors, proposed by practitioners, based on the results of international multicenter studies, as well as on the recommendations of scientific societies, are considered.
Voenno-medicinskij žurnal. 2019;340(5):63
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Gastrointestinal stromal tumor of the small intestine (clinical observation)

Zabelin M.V., Pogosov N.V., Krainyukov P.E., Skorobogatov V.M., Kim D.Y., Safonov A.S.


Materials of clinical observation of the case of gastrointestinal stromal tumor of the small intestine and the combined treatment in this pathology are presented. Patient M., aged 71 years, was treated for severe iron deficiency anemia for 1.5 months before admission. According to MRI of the pelvic organs in the projection of the right ovary a volumetric cystic-solid neoplasm was determined. After a clinical examination of the patient, it was decided to perform surgery with laparoscopically assisted access. Intraoperatively, a tumor of the small intestine was determined in the abdominal cavity without invasion into adjacent organs and tissues. The area of the intestine with a tumor after mobilization is brought out, resected over, a hardware small-intestinal anastomosis of the «side-to-side» type is formed. On the 7th day was discharged in satisfactory condition. At the place of residence, the patient underwent targeted therapy: for 6 months she received imatinib at a dosage of 400 mg/day. Based on the experience of surgical treatment of 67 patients with similar pathology, it was concluded that the use of laparoscopic technology allows to reduce intraoperative trauma, achieve early activation of patients, minimize bed-time and contribute to the achievement of good oncological treatment results.
Voenno-medicinskij žurnal. 2019;340(5):64-66
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Experience in performing a simultaneous operation in the case of a gunshot wound to the chest

Skorobogatov V.M., Salimov D.S.


A clinical case of a chest gunshot wound in a private conscript is described. On admission, a gunshot (bullet) blind penetrating wound of the left half of the chest, a closed injury of the abdomen was diagnosed. Based on radiography and computed tomography data, combined damage to the chest and abdomen was established; bullet blind penetrating wound of the left half of the chest with a foreign body S9 lung; closed injury of the abdomen with damage to the spleen 2 degrees. According to the conclusion of the consultation, the patient was shown a planned simultaneous operation in the volume of laparotomy, splenectomy, revision of the left dome of the diaphragm, thoracoscopic resection of the S9 left lung with a foreign body (bullet). At the first stage of the operation, median laparotomy was performed, revision of the abdominal organs and the left diaphragm dome. Adhesiolysis, evacuation of the subphrenic hematoma, typical splenectomy, drainage of the left subdiaphragmatic space were performed. At the second stage, after a thoracoscopic revision of the organs of the left hemithorax, an atypical resection of the IX segment of the lung with a foreign body was performed using an endoscopic stapler. The postoperative period was uneventful. This clinical case shows the possibility of performing a planned simultaneous operation («laparotomy-thoracoscopy») in the early periods after a gunshot wound to the lung.
Voenno-medicinskij žurnal. 2019;340(5):66-68
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Voenno-medicinskij žurnal. 2019;340(5):68
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The P.V.Mandryka Central Military Clinical Hospital: a brief history

Simonenko V.B., Abashin V.G., Satsukevich V.N.


The historical data on the creation, formation and development of the «1st Therapeutic Hospital of the Red Cross of the Field Staff of the Revolutionary Military Council» - later the P.V.Mandryka Central Military Clinical Hospital. The presented 100-year period encompasses the Civil War, the pre-war and war period of 1937-1945, the construction of new hospital complexes in Krasnogorsk and Sokolniki. The stages of the creation of the sanatorium department in the village of Bolshevo and the system of dispensary monitoring of officers and generals of the command staff of the Armed Forces are reflected. The basic data on the hospital management and the name change of the institution over 100 years are presented.
Voenno-medicinskij žurnal. 2019;340(5):69-77
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«Immortal regiment» - «Immortal medical battalion»: people and destinies in the history of the hospital

Simonenko V.B., Abashin V.G., Satsukevich V.N., Singilevich D.A., Travin N.O.


Presents brief data on the history of the P.V.Mandryka Central Military Clinical Hospital during the Great Patriotic War and information about some employees of the hospital - participants of the Great Patriotic War of 1941-1945. Some biographies are illustrated with photographs. The article is based on materials from the archive and the museum of the hospital, the memoirs of veterans and relatives of front-line soldiers, data from the Military Medical Museum of the Ministry of Defense of the Russian Federation.
Voenno-medicinskij žurnal. 2019;340(5):77-87
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Voenno-medicinskij žurnal. 2019;340(5):88-90
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Voenno-medicinskij žurnal. 2019;340(5):90-93
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Scientific-practical conference «Actual issues of medical rehabilitation of cardiac patients» in the Medical and Rehabilitation Clinical Center

Bagramyan I.G., Kulenko P.I., Molchanov B.A.


Based on the Medical and Rehabilitation Clinical Center of the Ministry of Defense of the Russian Federation in October 2018, the Vth Scientific and Practical Conference «Actual Issues of Medical Rehabilitation of Cardiac Patients» was held. The conference was attended by experts in the field of cardiac rehabilitation, including experts from the S.M.Kirov Military Medical Academy, the P.V.Mandryka Central Military Clinical Hospital, the A.A.Vishnevsky 3rd Central Military Clinical Hospital, Central military clinical sanatorium «Arkhangelsk». The conference summarized and systematized the experience gained by experts in the field of medical rehabilitation, cardiology and cardiac surgery, identified the main ways of further development of medical rehabilitation in medical organizations.
Voenno-medicinskij žurnal. 2019;340(5):94-96
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