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Vol 340, No 7 (2019)


Organization of medical care in a tactical zone of hostilities during modern war

Krainyukov P.E., Polovinka V.S., Abashin V.G., Stolyar V.P., Bulatov M.R., Katulin A.N., Smirnov D.Y.


Analyzed data from literary sources, reflecting the state and prospects of development of the system of medical care in the conditions of modern (hybrid, network-centric) war. The tendencies in the development of individual means of protection of servicemen and individual first aid equipment of the leading countries of the world (USA, Israel, etc.) are described. Increasing the level of military medical training of personnel, the saturation of modern means of providing medical care will reduce the number of errors leading to adverse outcomes for the wounded and injured, reduce the number of irretrievable losses during the fighting.
Voenno-medicinskij žurnal. 2019;340(7):4-13
pages 4-13 views

On the requirements of sanitary legislation for the design of buildings and structures for treatment-and-prophylactic organizations

Aleksandrov A.V., Polyakov V.S., Yumanov A.P.


Currently, the provision of federal regulatory acts on the provision of land for construction is canceled only if there are sanitary-epidemiological conclusions on the compliance of the intended use of sanitary regulations. As a result, in the preparation of project documentation the requirements for the placement of construction objects for organizations engaged in medical activities are not fully considered. This creates prerequisites for the possible erection of buildings and structures that do not meet sanitary and epidemiological requirements. Upon completion, this circumstance will not allow the hospital to issue a positive sanitary-epidemiological conclusion and a license to carry out medical activities. It is proposed to amend the existing legal documents to prevent such situations.
Voenno-medicinskij žurnal. 2019;340(7):14-16
pages 14-16 views

Modern approaches to the pathogenetic therapy of toxic convulsive syndrome

Chepur S.V., Pluzhnikov N.N., Yudin M.A., Fedonyuk V.P., Nikiforov A.S., Ivanov I.M., Subbotina S.N., Bykova A.F., Tyunin M.A., Kolesnikov A.M.


The article is devoted to a comparative analysis of existing approaches to relief of convulsive syndrome of toxic etiology, as well as the prospects for the development of anticonvulsants. The effects of pharmacological drugs used in the treatment of poisoning, accompanied by convulsive syndrome. On the experimental models of intoxication with convulsive poisons and status epilepticus, modern and prospective schemes for stopping generalized clonic-tonic convulsions, including combinations of basic (benzodiazepines and barbiturates) and adjuvant (auxiliary) therapeutic agents, as well as means and methods for prolonging the pharmacological action of various dosage forms are evaluated. The analysis of changes in the structures of the central nervous system arising in the course of the pathological process that develops in the acute period of organophosphate poisoning is presented. The possible directions of improving the means of pathogenetic therapy of toxic convulsive syndrome are grounded.
Voenno-medicinskij žurnal. 2019;340(7):17-25
pages 17-25 views

Expert assessment of gunshot injuries from a traumatic pistol MR-341 «KHAUDA»

Leonov S.V., Pinchuk P.V., Gonikshtein Y.G.


The article describes the main tactical and technical characteristics of the traumatic firearm of the brand MR-341 «KHAUDA» and its ammunition. The morphology of damage and the topography of the deposition of shot products when shooting from this sample of traumatic brand firearms on cotton fabric targets from a distance of up to 175 cm have been studied experimentally. MP-341 «KHAUDA», as well as to detail the zone of close range and the distance of the shot.
Voenno-medicinskij žurnal. 2019;340(7):25-28
pages 25-28 views

Clinical and economic analysis of methods of surgical treatment of discogenic lumbosacral radiculopathy

Kravtsov M.N., Tegza V.Y., Gaidar B.V., Svistov D.V.


The results of a prospective cohort study with the inclusion of two groups of patients are presented (follow-up period is 6-42 months). The 1st group included 110 patients after undergoing percutaneous endoscopic lumbar discectomy, the 2nd group included 331 patients after lumbar microdiscectomy. Clinical efficacy was assessed using the patient satisfaction score with the result of MacNab surgical treatment. Economic efficiency was determined by the amount of direct medical and indirect costs. Intergroup differences in outcomes, assessed by clinical outcome, incidence of complications, relapses and reoperations, were not statistically significant. The use of percutaneous endoscopic lumbar discectomy causes a significant reduction in costs, which makes this treatment method more cost-effective.
Voenno-medicinskij žurnal. 2019;340(7):29-36
pages 29-36 views

Gastric polyps as a precancer: the experience of therapeutic and diagnostic tactics in a multidisciplinary hospital

Fokin Y.N., Shklovskii B.L., Tatarin V.S., Savvin V.Y., Baksheev V.I.


The experience of diagnosis and treatment of gastric polyps in a multidisciplinary hospital is presented. It is emphasized that the main task in admission of patients with gastrointestinal neoplasia is the establishment in the early stages of a final diagnosis and the conduct of specialized therapy in accordance with the licensed specialties. At the same time, endoscopic polypectomy is low-traumatic and provides a reduction in the length of stay of patients in the hospital, early rehabilitation, low incidence of recurrence of the disease - 5%. The authors provide an integrated system for the diagnosis and treatment of patients with gastric neoplasms as the basis for effectively achieving favorable immediate and long-term treatment results.
Voenno-medicinskij žurnal. 2019;340(7):36-44
pages 36-44 views

Prospects for the use of nanotechnology in the treatment of bacterial infections

Patsenko M.B., Esipov A.V., Balabanyan V.Y., Gelperina S.E.


Antibiotics of various classes are widely used to treat infections, but antimicrobial therapy is significantly complicated by the resistance of pathogens to these drugs. In addition, the lack of selectivity of the action of antibiotics leads to the occurrence of side effects from various organs and systems. It is possible to increase the effectiveness of antibacterial therapy and reduce adverse side effects by creating nanoscale dosage forms of antibacterial drugs. Nano-sized (colloidal) drug carriers, especially nanoparticles, have unique physicochemical properties that allow them to deliver antibiotics to target cells or organs. The use of nanoscale forms of drugs will help solve the problem of resistance of pathogens to antibiotics.
Voenno-medicinskij žurnal. 2019;340(7):44-51
pages 44-51 views

Interdisciplinary approach in the treatment of partial absence of teeth in patients with combined pathology

Lebedinskaya O.F., Shikhanov A.V., Belozerova L.I., Nikitenko D.O., Shagaeva D.M.


The partial absence of teeth is the cause of more than half of all visits to dental clinics. However, in addition to the absence of teeth, patients are diagnosed with another pathology that complicates treatment, the success of which is possible only with the coordinated actions of physicians of various specialties. An interdisciplinary approach implies adherence to the principles of comprehensive diagnosis and rehabilitation of the patient. During the examination, it is necessary to strive to obtain objective data on the dental system, including the fact that signs of various general somatic pathology can be detected in the oral cavity, which should be treated by non-dental specialists.
Voenno-medicinskij žurnal. 2019;340(7):51-55
pages 51-55 views

Clinical case of cystic lymphangioma of the mesentery of the small intestine

Chumanov A.Y.


A clinical observation of cystic lymphangioma of the mesentery of the small intestine in a conscript soldier complicated by rupture of a cyst and diffuse reactive serous peritonitis is presented. A laparotomy and revision of the abdominal organs revealed a multitude of cysts, ranging from 0.3 to 12 cm in diameter, emanating from the mesentery of the small intestine. The largest and most mobile cysts are removed. As a result of treatment (infusion therapy, analgesics, antibiotics, nonsteroidal anti-inflammatory drugs, anticoagulants), the patient’s condition improved. This observation shows the diversity of the clinical manifestations of mesenteric lymphangioma.
Voenno-medicinskij žurnal. 2019;340(7):55-57
pages 55-57 views

On ensuring epidemiologic safety and prevention of HIV infection in a multidisciplinary hospital

Esipov A.V., Breskina T.N., Antoshina I.N., Kazakova T.V., Yurev I.V.


Anti-epidemic measures, including regarding AIDS, occupy one of the central places in the system of ensuring the safety of medical practice. Standardization and algorithmization of work with unexplored, potentially HIV-infected patients is of decisive importance in ensuring the safety of medical personnel and patients of a multidisciplinary hospital. In order to implement these tasks in clinical practice, a local regulatory document of a medical organization has been developed - the standard operating procedure «Procedure for medical workers when treating a potentially HIV-infected patient in FSBI “The A.A.Vishnevskiy 3rd CMCH” of the Ministry of Defense of the Russian Federation». The use of standard operating procedures allows minimizing the risks of HIV infection and is the basis for training medical personnel and acquiring the necessary competencies, skills and abilities.
Voenno-medicinskij žurnal. 2019;340(7):58-61
pages 58-61 views

Comparative evaluation of the effectiveness of complexes of medical rehabilitation of flight personnel with the autonomic dysfunction of the cardiovascular system

Vovkodav V.S., Godilo-Godlevskii V.A., Churilov Y.K., Richei I.I., Yakovleva E.V.


The analysis of the effectiveness of the complex rehabilitation of flight personnel with vegetative dysfunction of the cardiovascular system in the main (28 people) and control (30 people) groups was carried out. The patients of the control group underwent only physical rehabilitation provided for the flight personnel, including the metered dynamic exercise load (exercise bike) and the metered static exercise load (work on the training complex). In addition to the volume of physical rehabilitation indicated above, the flight crew of the main group was interviewed by a psychotherapist (medical psychologist), with the aim of correcting the vegetative status using the drugs Bellatamininal or Grandaxin. The higher efficiency of the combined use of physical rehabilitation, psychotherapy and pharmacological support is shown.
Voenno-medicinskij žurnal. 2019;340(7):62-67
pages 62-67 views

Current state of the problem of assessing the severity of the explosive injury of the lower extremities

Anisin A.V., Logatkin S.M., Denisov A.V.


The review is devoted to the problem of assessing the severity of the explosive injury of the lower extremities. In the wars of the XXI century mine explosive injury of the lower limbs accounts for up to 69% of all combat damage, which is associated with the specifics of the conduct of hostilities. Pathogenetically and clinically explosive injury is fundamentally different from the injuries of peacetime, and therefore it is not possible to use the estimated scales of severity of injuries of the lower extremities, developed on the clinical material of peacetime. Attempts to use natural modeling for this purpose, in particular, human corpses and anthropomorphic mannequins, did not help in creating a clinically acceptable scale assessing the severity of the explosive injury of the lower limb, and the development of virtual numerical models encounters great difficulties. In this situation, the clinical approach to assessing the severity of the explosive injury of the lower limb, based on the analysis of case histories and the results of dynamic monitoring of the wounded, remains real. As an example of the implementation of such an approach, the Bastian classification proposed in 2014 is considered.
Voenno-medicinskij žurnal. 2019;340(7):68-69
pages 68-69 views

Formation and development of rehabilitation of cardiac patients in the branch № 1 of the Medical and Rehabilitation Clinical Center of the Ministry of Defense of the Russian Federation

Khmil A.Y., Belov D.F., Molchanov B.A.


The branch № 1 of the LRCC of the Ministry of Defense of the Russian Federation has created a material and personnel base for the medical rehabilitation of cardiac patients, and appropriate technologies and techniques are being developed and improved. Comprehensive medical rehabilitation programs, including cardiovascular exercises using cyclic simulators, individually selected physiotherapy treatments, modern methods of psychotherapeutic correction, significantly increase the patient’s tolerance to physical activity, form the motivation for lifestyle correction, lead to an improvement in its quality. This ensures that patients achieve a physical level sufficient to return to their work and service activities.
Voenno-medicinskij žurnal. 2019;340(7):69-72
pages 69-72 views

Clinical case of application of the technique of minimally invasive drainage in the treatment of subphrenic abscess

Panov V.V., Kim I.Y., Malakhanov S.N.


A clinical case of the use of endoscopic equipment in the treatment of a subdiaphragmatic abscess as a complication after a surgical intervention for a closed abdominal trauma with splenic rupture and intra-abdominal bleeding is described. The peculiarity of the given example is an atypical clinical picture of a purulent postoperative complication, taken as the formation of a post-traumatic pancreatic cyst.
Voenno-medicinskij žurnal. 2019;340(7):72-74
pages 72-74 views

Minimally invasive treatment of multiple stones of the diverticulum of the calyx of the right kidney

Protoshchak V.V., Paronnikov M.V., Sivakov A.A., Kushnirenko N.P.


A clinical case of a combination of urolithiasis with an abnormal development of the kidney in a 25-year-old patient is described. Computed tomography revealed a diverticulum of the middle calyx of the right kidney and a non-uniform stone 15ґ20 mm in size located in it. Multiple small stones of the middle calyx of the right kidney were visualized with the help of percutaneous mini-nephroscopy. When performing the manipulation, 40 small stones were removed from the diverticulum. After 3 months, at the control examination, no stones were found in the diverticulum of the calyx of the kidney, almost complete regression of retention changes was determined.
Voenno-medicinskij žurnal. 2019;340(7):74-75
pages 74-75 views

Use of antioxidant protection for the stabilization of static-locomotor functions - signs of postoperative cognitive dysfunction in laparoscopic cholecystectomy

Karpitskaya S.A., Kharisov A.M., Khairullin A.R., Ershov A.V.


The dynamics of locomotor functions in the perioperative period during laparoscopic cholecystectomy in 90 patients was studied. Clinical and laboratory data were analyzed in parallel with the data of computer stabilography in patients without the use of antioxidant antioxidants and with the use of two antihypoxant antioxidants, mafusol and cardioxipin. Stabilographic studies revealed criteria for the perioperative administration of antioxidant antioxidants to reduce postoperative cognitive dysfunction during general anesthesia of laparoscopic cholecystectomy.
Voenno-medicinskij žurnal. 2019;340(7):75-79
pages 75-79 views

Experience of the use of wound dressing «Nano-Aseptic» as a mean of purulent complications prevention

Stetsenko B.G., Diveev V.A., Siryakov M.V., Ivanov G.G., Isaev K.A., Ivanova G.V.


The report is devoted to the prevention of infectious complications in the treatment of wounds. The paper considers a promising local means «Cloth with nanostructured silver dressing «Nano-Aseptica». Based on the results of treatment of patients with surgery (planned, emergency surgery), trauma and gynecological profile, a conclusion was made about the effectiveness of the use - reducing the bed-day, increasing the bed turnover.
Voenno-medicinskij žurnal. 2019;340(7):79-80
pages 79-80 views

Experience of using the device for non-invasive blood irradiation with ultraviolet radiation «Ecosvet-1» in the complex treatment of purulent-inflammatory diseases of soft tissues

Markevich P.S., Alekhnovich A.V., Kislenko A.M., Esipov A.A.


The article describes the application of the device for non-invasive blood irradiation with ultraviolet radiation «Ecosvet-1» in the clinical practice of a multidisciplinary hospital. The effectiveness of the biological effect of the device was evaluated according to the results of complex treatment of 119 patients with mine-explosive wounds of the extremities, purulent-inflammatory diseases of soft tissues and erysipelas: in comparison with the control group (n=109), a decrease in hospital stay was 1.8-4.5 days, decrease in the number of complications - by 23%, normalization of laboratory parameters in earlier periods - by 2 days, reduction of microbial contamination - by 8.3%.
Voenno-medicinskij žurnal. 2019;340(7):80-81
pages 80-81 views

The Solnechnogorsk military hospital - 70 years

Dolgov E.N., Stetsenko B.G., Dzhagupov I.V.


The article is dedicated to the 70th anniversary of the Solnechnogorsk military hospital, formed in July 1949 in the village. Kosteryovo, Vladimir region. Most of the personnel then consisted of doctors and nurses - participants of the Great Patriotic War. Subsequently, the capacity of the hospital increased to 400, and then to 500 beds, it becomes the district military hospital of the Moscow Air Defense District. At present, modern technologies in otorhinolaryngology, ophthalmology, urology, gynecology, dentistry, physiotherapy, manual therapy have entered the daily practice of the hospital. Intravenous and cutaneous laser therapy, ozone therapy, membrane plasma exchange, etc. are widely used.
Voenno-medicinskij žurnal. 2019;340(7):82-84
pages 82-84 views

Background of the establishment of the Department of military and military-sanitary disciplines at the Military medical academy

Karpenko I.V., Rusanov S.N., Sergeeva M.S.


The article discusses the historical background of the organization of the first department of military and military sanitary disciplines at the Military Medical Academy of the Red Army. It is noted that the establishment of this department within the walls of the country’s oldest medical school, which trained military doctors, was completely natural. The first decade of the 20th century was marked by a significant complication of the tasks of medical support of the army. New historical conditions were due to the use of new weapons and the mechanization of the army. All this led to the awareness of the need to create a scientific and methodological center for studying the problems of medical support for the army during military operations and the training of military medical personnel. The answer to this historical inquiry was the establishment in 1929 of the first in the USSR department of military and military sanitary disciplines at the Military Medical Academy of the Red Army.
Voenno-medicinskij žurnal. 2019;340(7):85-89
pages 85-89 views

Lenta novostey

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Voenno-medicinskij žurnal. 2019;340(7):89
pages 89 views

Naznacheniya. Yubilei

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Voenno-medicinskij žurnal. 2019;340(7):90-91
pages 90-91 views

Lenta novostey

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Voenno-medicinskij žurnal. 2019;340(7):92-93
pages 92-93 views

Neurosurgical conference «The Burdenkovsky meetings» at the N.N.Burdenko Main Military Clinical Hospital

Ovchinnikova M.B.


A brief report on the international neurosurgical conference held at the N.N.Burdenko Main Military Clinical Hospital was presented. The latest endoscopic and minimally invasive technologies in spine and spinal cord surgery, the topics of «artificial intelligence», the development of active use of robots in neurosurgery, virtual simulation of operations, a personalized approach, virtual simulators, cadet courses, etc. minimally invasive operations on the spine and spinal cord, which was distinguished by equipment, illustrative and friendly environment.
Voenno-medicinskij žurnal. 2019;340(7):94-96
pages 94-96 views

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