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Vol 340, No 10 (2019)


Mathematical models for calculating the economic efficiency of introducing the results of project activities into the practice of military health

Trishkin D.V., Gurov A.N.


The article provides specific mathematical models for calculating the economic efficiency of introducing the results of project activities in the practice of medical support for troops. The overall economic effect is determined based on an innovative result with a financial effect, prevented economic damage, medical effect and the economic effect of saving money, assessing the quality of life associated with health, social, managerial, medical and environmental, educational, advertising and scientific and technical effects. After correlating the effect with the costs, the economic efficiency of introducing the results of project activities into the practice of medical support for the troops is calculated.
Voenno-medicinskij žurnal. 2019;340(10):4-13
pages 4-13 views

Hospital substituting technologies in military medical organizations

Rusev I.T., Karailanov M.G., Fedotkina S.A., Prokin I.G., Borisov D.N., Zakurdaev V.V., Stepushkina G.A.


The development of hospital-replacing forms of medical care is determined by the need of the population in this type of medical services, as well as the need for rational and efficient use of financial resources and material and technical resources. It is shown that hospital-substituting technologies provide a more efficient use of bed capacity, a reduction in cases of unjustified hospitalization, and can improve the efficiency of work while maintaining the quality of medical care provided. The results of a comparative analysis of various hospital-replacing forms of medical care according to the criteria of medical, social and economic efficiency are given, and a list of key indicators for evaluating the work of a day hospital has been determined.
Voenno-medicinskij žurnal. 2019;340(10):14-21
pages 14-21 views

The provision of qualified and specialized surgical care to soldiers with limb injuries during a counter-terrorist operation

Nikitin V.F., Bulavin V.V., Vorona A.A., Remizov Y.I., Olenev N.I.


680 case histories, clinical records, and evidence of illness of military personnel who were injured in a limb in a counter-terrorist operation in the North Caucasus (1999-2001) were studied. The surgical interventions of the wounded in the amount of qualified and specialized surgical care were analyzed, including various types of metal osteosynthesis (extra focal, intramedullary, bone) in 29.5% of the wounded, skeletal traction in 9% and gypsum immobilization in 48%. It was shown that metal osteosynthesis at the stage of providing qualified surgical care caused more suppuration than at the stage of specialized surgical care, which led to serious complications, sometimes with an unfavorable outcome, lengthening the duration of treatment and, as a rule, to dismissal from military service. An analysis of the evidence of illness of the wounded with gunshot fractures of the limbs, especially with combined injuries, confirms the need for surgical care according to emergency indications at the stage of qualified care with the earliest possible evacuation to the stage of specialized surgical care.
Voenno-medicinskij žurnal. 2019;340(10):22-27
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Role of additive technologies in modern reconstructive surgery.

Tereshchuk S.V., Ivanov S.Y., Sukharev V.A.


Modern technologies allow not only to virtually plan a reconstructive surgery, but also to obtain patterns for resection and osteotomy, individual titanium reconstructive plates based on the results of planning. In the period from 2007 to 2017 in the center of maxillofacial surgery and dentistry of the N.N.Burdenko Main Military Clinical Hospital was performed 144 operations to eliminate bone defects of various localization with the use of additive technologies. In 136 (93%) cases, these were defects of the bones of the facial skeleton and the cranial vault, in two cases - the clavicle, in one - the scaphoid bone, in one - the radius, in two - the humerus, in two cases - the femur defect. To eliminate defects in 125 (87%) cases, revascularized autografts were used, in 19 (13%) - alloplastic materials. The clinical observations of the successful use of additive technologies are given as examples. The use of surgical models and templates during reconstructive operations reduces the time of the operation itself and reduces the number of postoperative complications.
Voenno-medicinskij žurnal. 2019;340(10):28-32
pages 28-32 views

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Voenno-medicinskij žurnal. 2019;340(10):32
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A risk-based model of control and surveillance activities in the implementation of the federal state sanitary and epidemiological surveillance in the Armed Forces

Azarov I.I., Golubkov A.V., Polyakov V.S.


Information is given on the stages of development and the current state of state sanitary and epidemiological surveillance in the Armed Forces of the Russian Federation. Actual aspects of the control and surveillance activities of the centers of the state sanitary and epidemiological surveillance of the Ministry of Defense are highlighted, the need for a transition to its risk-based model is shown. A list of activities whose implementation is necessary for such a transition is presented. The proposed model requires testing in one or two military districts to obtain evidence of improving the quality of surveillance activities and reducing the incidence of infectious and mass noncommunicable diseases (poisonings) among the personnel of the RF Armed Forces. It is assumed that the introduction of a risk-based model will provide optimal efficiency in the use of labor, material and financial resources involved in the implementation of state sanitary and epidemiological surveillance, reduce costs and increase the effectiveness of the centers of state sanitary and epidemiological surveillance of the Ministry of Defense.
Voenno-medicinskij žurnal. 2019;340(10):33-40
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On the causes of contracted tuberculosis of military personnel

Beznosik R.V., Grishin V.K., Aksenova K.I.


Over the past 5 years, the absolute number of conscripts contracting tuberculosis has decreased by 33.5%, and the incidence rate has decreased by 1.5 times. At the same time, tuberculosis among those drafted into the Armed Forces continues to be an important problem for the military medical service. For early detection of tuberculosis patients and prevention of the development of the tuberculosis process among them, it is necessary not only a thorough medical examination of the young replenishment, but also a purposeful medical history collection (contact with tuberculosis patients, results of tuberculin tests before conscription, placement in dispensary observation groups at children’s TB clinics, etc.). Parts of such military personnel must be considered as belonging to the high-risk group for tuberculosis, organize monitoring, periodic examination and conduct of health-improving measures in accordance with the Guidelines for medical examination of military personnel in the Armed Forces of the Russian Federation.
Voenno-medicinskij žurnal. 2019;340(10):40-44
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Influence of the intensity of maintenance work on special equipment on the health status of personnel

Zavirskii Y.V., Zemlyannikov D.A., Maksimov S.G., Pankratov V.V., Poluboyarinov V.N.


A comparative analysis of the incidence of specialists of assembly teams and personnel of other units. The incidence of military personnel was estimated considering the number of initial complaints about diseases of the nervous system, digestive systems and blood circulation. To assess the influence of factors of military labor on the health status of specialists, a study was made of its dependence on the intensity of maintenance of special equipment. It was revealed that the specialists of assembly crews are 1.5 times more likely than the military personnel of other units to have circulatory system diseases and there is a connection between the intensity of work and the incidence of specialists. It is concluded that it is necessary to improve the system of medical support for personnel, to develop optimal working and resting conditions, to ensure the possibility of a full restoration of the functional state of the body of military personnel after performing maintenance work on special equipment.
Voenno-medicinskij žurnal. 2019;340(10):45-47
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Promising areas of pharmacological correction of serviceability of military personnel

Anokhin A.G., Ivchenko E.V., Kuzmin A.A., Fateev I.V., Soshkin P.A.


The data on the nature of the loads of motor-volitional class of specialties are presented. The mechanisms for the formation of fatigue, underlying the decline in efficiency. The directions of pharmacological effects on factors limiting the performance of military personnel of this class are considered. It has been established that the most promising areas should be considered: activation of anabolic functions with simultaneous replenishment of energy substrates, stimulation of the nervous system, improvement of respiratory function and oxygen capacity of the blood, fighting hypoxia, inhibiting free radical processes, preventing immunodeficiency states, maintaining coordinated organs and systems. Within the selected areas, groups of drugs that are promising for study as a means of improving the professional performance of the motor-volitional class servicemen are justified.
Voenno-medicinskij žurnal. 2019;340(10):48-54
pages 48-54 views

Change in bone mineral density in patients with multiple myeloma

Kryukov E.V., Troyan V.N., Rukavitsyn O.A., Kozyrev S.V., Alekseev S.A., Pop V.P.


Skeleton damage is the main clinical and radiological syndrome and is observed in all patients with multiple myeloma. After courses of standard chemotherapy and subsequent high-dose chemotherapy with autotransplantation of hematopoietic stem cells, some positive dynamics is observed in the form of an increase in bone density of vertebral bodies, which is confirmed by the results of dual-energy X-ray absorptiometric densitometry and computed tomography.
Voenno-medicinskij žurnal. 2019;340(10):55-56
pages 55-56 views

To the issue of quality management in healthcare based on standards

Gruzdeva A.A., Khubulava G.G., Ilin M.V., Kharitonova E.A., Mushnikov D.L.


To carry out management and control over medical activities, the standards of quality of care have been approved. However, the current standard does not have sufficient evidence of pharmacotherapy: drugs with unproven efficacy for this nosology are included (50%). In this regard, the standards require refinement to include drugs with proven effectiveness. The study allowed us to identify the leading groups of problems of standards implementation at the regional level: administrative, organizational, methodological, informational, socio-psychological, sociocultural, which formed the basis for the development of new directions for optimizing the use of standards relating to medical personnel, patients, insurance organizations, scientific research.
Voenno-medicinskij žurnal. 2019;340(10):57-58
pages 57-58 views

The effect of lithium chloride on the activation of neutrophils by the action of bacterial components in vitro

Karpitskaya S.A., Grebenchikov O.A., Kharisov A.M., Khairulin A.R., Ershov A.V., Prikhod’ko A.S., Kasatkina I.S., Shabanov A.K., Kuzovlev A.N.


Activation of neutrophils is a mandatory stage and a sensitive marker of systemic inflammatory conditions that can lead to the development of multiple organ failure. The purpose of the study was to study the anti-inflammatory effect of lithium chloride on human neutrophils in vitro. The study was carried out on 5 healthy donors isolated from blood neutrophils, some of which were activated using 100 mkMfMLP and 100 ng/ml lipopolysaccharide, then their activity was evaluated using fluorescent antibodies to CD11b and CD66b degranulation markers. Intact and activated neutrophils were treated with a solution of lithium chloride at a concentration of 9 mmol. Lithium chloride reduces the level of neutrophil activation, having an anti-inflammatory effect on neutrophils preactivated by bacterial components, and tends to decrease the expression level of CD11b and CD66b molecules on the surface of intact neutrophils, inhibiting their activation and degranulation.
Voenno-medicinskij žurnal. 2019;340(10):58-60
pages 58-60 views

Long-term results of treatment of tunnel neuropathies of the upper limb

Popov A.P., Rogov Y.V., Astakhova T.P., Petrov S.V.


A study on the development of a scientifically-based system for the diagnosis and complex treatment of patients with tunnel syndromes is presented. A total of 103 patients aged 19 to 72 years with tunnel syndromes (carpal canal, cubital canal, Guyon canal) of the upper limb were examined. A clinical and neurological examination, X-ray, electroneuromyography, and ultrasonography were performed for all patients. Early diagnosis and adequate treatment of tunnel syndromes, depending on the stage of nerve compression, are two fundamental factors that play an important role in preventing the development of gross, sometimes irreversible, motor, sensory and autonomic disorders of the hand.
Voenno-medicinskij žurnal. 2019;340(10):60-63
pages 60-63 views

Distant ischemic preconditioning in increasing resistance to physical activity

Kudryashov V.S., Tsygan V.N.


Data on the use of the method of distant ischemic preconditioning as a non-drug method for increasing the physical performance of a healthy person has been published in the literature. The report provides an overview of studies in which it was shown that distant ischemic preconditioning is potentially able to increase such indicators of physical performance as the maximum oxygen consumption, time to load to failure, power of the load performed, etc. The effect was especially significant when applying the method during several consecutive days.
Voenno-medicinskij žurnal. 2019;340(10):63-65
pages 63-65 views

The prevalence and definition of risk groups for sleep apnea in military personnel

Khmil A.Y., Belov D.F., Steklov V.I., Khokhlov V.F., Zaitsev A.A., Mostovoi L.V.


To assess the prevalence of sleep apnea in conscripts and contract soldiers, screening was performed using monitoring computer pulse oximetry (216 people). It was revealed that for conscripts, the problem of sleep apnea is not significant (12% are mild), while for contracted soldiers this problem is of serious importance, especially in the age group over 40 (prevalence reaches 46%, severe forms up to 11%). The frequency of contracted sleep apnea in military personnel to a large extent depends on age and the presence of concomitant obesity, as well as hypertrophy of palatine tonsils of the 3rd degree. It is proposed to carry out computer-assisted pulse oximetry during medical examination under contract with overweight, especially in combination with hypertrophy of the tonsils, as well as certain categories of military personnel (whose activities are related to the transportation of people in transport).
Voenno-medicinskij žurnal. 2019;340(10):65-68
pages 65-68 views

Complex characteristics of clinical, pathological and microbiological features of ulcerative colitis

Katorkin S.E., Zhestkov A.V., Suvorova G.N., Myakisheva Y.V., Lyamin A.V., Andreev P.S., Davydova O.E., Kruglov E.E.


The results of a comprehensive examination of 46 patients with ulcerative colitis are presented. In 25 patients, a histomorphologic and microbiological study of biopsy specimens of the colon wall was performed. Morphological signs of ulcerative colitis were present in 24 patients, in one case Crohn’s disease was diagnosed. The full range of diagnostic signs characteristic of ulcerative colitis was determined in 19 patients. In 50% of cases, a pronounced activity of the inflammatory process was observed, in 30% - moderate, in 20% - its minimum degree. In patients with moderate and severe inflammation in biopsy specimens, in 70.9% of cases, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Aeromonas hydrophyes and mixed infection were detected. In patients with moderate and severe disease, the course of treatment, considering the results of tests on the microflora, was supplemented with antibacterial therapy. The above complex characteristic of ulcerative colitis shows the need for a microbiological study of biopsy specimens of the intestinal wall of patients, which makes it possible to choose antibacterial chemotherapeutic agents with proven efficacy against the identified microorganism.
Voenno-medicinskij žurnal. 2019;340(10):68-71
pages 68-71 views

Pirogov relics and the «N.I.Pirogov Museum» in the Military Medical Museum of the Ministry of Defense of the Russian Federation

Budko A.A.


In December 2018, the «N.I.Pirogov Museum» was opened at the Military Medical Museum of the Ministry of Defense of the Russian Federation. The latter is, as it were, the successor to the first museum of N.I.Pirogov, created on the initiative of the Russian Surgical Society at the end of the XIX century in St. Petersburg, the Surgical Museum of the Imperial Medical-Surgical Academy and the Museum of the «Instrumental Hut» of the St. Petersburg Instrument Plant. The «N.I.Pirogov Museum» is a recognition of the genius of domestic and foreign medicine, the great anatomist and surgeon, a pioneer in many fields of medicine, the founder of military field surgery and the medical support system of the troops, a major organizer of military sanitary affairs, an outstanding teacher and public figure.
Voenno-medicinskij žurnal. 2019;340(10):72-76
pages 72-76 views

Scientist, warrior, patriot (on the 120th birthday of Academician N.S.Molchanov)

Salukhov V.V., Shustov S.B., Yakovlev V.A., Kurenkova I.G.


The article is dedicated to academician Nikolai Molchanov - a professional military man, a doctor, a participant in three wars and a lieutenant general of the medical service. N.S.Molchanov is a major scientist who made a significant contribution to the development of problems of pulmonology, cardiology, post-traumatic visceral pathology. The author of 250 publications, 4 monographs, 5 textbooks. Under his leadership, 31 doctoral and 58 master’s theses were completed.
Voenno-medicinskij žurnal. 2019;340(10):76-78
pages 76-78 views

From the history of the organization of military hospitals in Saratov (second half of the 18th - early 20th century)

Ablezgov V.I., Andriyanova E.A., Zavyalov A.I., Suvorov V.V.


The article is devoted to the history of the organization and activities of military hospitals in Saratov to provide medical assistance to the military personnel of the Russian army in peacetime and during military conflicts in the second half of the eighteenth and early twentieth centuries. The role of public organizations and individuals in the deployment of additional hospitals during the Russo-Turkish War of 1877-1878, the First World War and the Civil War is shown.
Voenno-medicinskij žurnal. 2019;340(10):79-84
pages 79-84 views

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Voenno-medicinskij žurnal. 2019;340(10):84
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Trishkin D.V., Kraynyukov P.E., Simonenko V.B., Stavila A., Parfenyuk A.
Voenno-medicinskij žurnal. 2019;340(10):85-92
pages 85-92 views

Conference on hip joint endoprostheses at the Medical and Rehabilitation Clinical Center of the Ministry of Defense

Vinogradov A.V., Sorokin N.A., Chalyi A.N., Biryukov D.A.


The results of the work of the scientific-practical conference with international participation «Hip joint endoprostheses with a shortened femoral component are presented. Development prospects. Features of postoperative rehabilitation treatment», held March 22, 2019 in the medical and rehabilitation clinical center of the Ministry of Defense of the Russian Federation. During the conference, topical directions for improving trauma and orthopedic care were identified, such as the importance of promoting hip joint arthroplasty using shortened femoral components and coordinating actions between ambulatory trauma specialists, day hospitals, trauma departments and rehabilitation centers on the basis of a single methodological base, and developing and implementing uniform methods of conservative and operative treatment and rehabilitation based on criteria for evidence-based medicine, improving standards of care in young patients.
Voenno-medicinskij žurnal. 2019;340(10):93-95
pages 93-95 views

Conference «Medical and psychological rehabilitation: problems, trends, prospects» at the military health-resort «Sudak»

Kutsurenko S.A.


A brief report on the scientific-practical conference «Medical and psychological rehabilitation: problems, trends, prospects» was held in April 2019 at the health-resort «Sudak» - a structural unit of the Sanatorium-resort complex «Crimea» of the Russian Defense Ministry and dedicated to the 95th anniversary sanatorium.
Voenno-medicinskij žurnal. 2019;340(10):95-96
pages 95-96 views

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