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Vol 341, No 4 (2020)


Features of the organization of medical support for troops (forces) in the Arctic zone

Chernikov O.G., Kulnev S.V., Kupriyanov S.A., Soldatov E.A., Ovchinnikov D.V., Fisun A.Y.


Based on the analysis of domestic sources, scientific articles, the article reveals the geopolitical and economic importance of the development of the Arctic region. Factors affecting the organization of medical support for troops (forces) deployed in the Arctic are considered. The specifics of the medical support of troops (forces) determine the directions for improving its organization through the rational distribution of forces and means of the medical service and the effective use of its capabilities. The necessity of improving the system of disease prevention and providing medical assistance to personnel is shown. Topical areas are the development of new means of medical care and evacuation for use in the Arctic, the event of a telemedicine consultation system, and the improvement of the organization of the provision of qualified medical care.
Voenno-medicinskij žurnal. 2020;341(4):4-11
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Hospital-replacing technologies in domestic healthcare (review of literature)

Popov A.P.


The priority task facing domestic civil and military health care is to optimize budget financing of medical organizations at various levels, therefore, it is urgent to search for effective economic models for the provision of highly qualified outpatient care using hospital-replacing technologies. A literature review on this issue is provided.
Voenno-medicinskij žurnal. 2020;341(4):12-20
pages 12-20 views

Forensic reconstruction of the bodies of victims of explosive injuries based on dermatoglyphic studies

Bozhchenko A.P., Kapustin E.V.


The article describes the nature and types of symmetry as the properties of living organisms, the possibilities, and options for assessing the balance of the human body in solving reconstructive tasks of the forensic medical examination. The regularities of bilateral (mirror) symmetry of the papillary patterns of the palms were studied. A high degree of balance of dermatoglyphic signs is shown. It has been established that the types of models, rudiments of papillary ridges, and ridge counting between triradius have the most significant correspondence to each other on the right and left palms. Using the recommended set of informative dermatoglyphic signs, the forensic expert can reconstruct with high reliability the bodies of the victims of explosive injuries and solve the question of whether parts (fragments) of the body belong to one or more victims.
Voenno-medicinskij žurnal. 2020;341(4):21-25
pages 21-25 views

Community-acquired pneumonia: current clinical recommendations

Zaitsev A.A., Sinopalnikov A.I., Kryukov E.V.


The issues of diagnosis and treatment of community-acquired pneumonia are examined from the standpoint of modern requirements of national recommendations, Guidelines for the diagnosis and treatment of pneumonia in military personnel. The most important recommendations relate to empirical antimicrobial treatment regimens for mild community-acquired pneumonia in a hospital, the possibilities of determining C-reactive protein for diagnosing the disease and evaluating the effectiveness of the therapy. Attention is paid to the role of recommendations in real clinical practice, considering new legislative requirements, quality criteria for the care of patients with pneumonia.
Voenno-medicinskij žurnal. 2020;341(4):26-37
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Assessment of the quality of life of patients after surgical rehabilitation of an extremely severe open eye injury

Kulikov A.N., Shamrei D.V., Churashov S.V., Danilichev V.F., Grigorev D.V., Kokareva E.V.


The results of the study of indicators of the quality of life of patients after surgical rehabilitation in the outcome of an extremely severe open eye injury are presented. Examined 45 patients, aged 18 to 56 years. All examined revealed post-traumatic subatrophy of the eyeball of varying severity. The scope of the surgical intervention included the posterior evisceration of the eyeball with the implantation of an ophthalmic implant from porous polytetrafluoroethylene. Quality of life indicators were evaluated before surgery and at the final stage of cosmetic rehabilitation after selecting an individual thin-walled ocular prosthesis 1 month after surgical treatment. We used the general MOS SF-36 questionnaire and the special questionnaire «Quality of life of a patient with monocular vision». The results of the study indicate that the modern method of surgical rehabilitation of patients using an implant made of porous polytetrafluoroethylene significantly increases the level of socio-psychological rehabilitation in the complex treatment of patients who have suffered extremely severe open eyeball injury.
Voenno-medicinskij žurnal. 2020;341(4):38-41
pages 38-41 views

Modern biomarkers in the diagnosis of acute respiratory infections of the upper respiratory tract and determining the strategy of antibiotic therapy (review of foreign literature)

Yumanov A.P., Prohorova N.D., Storozhilov V.A.


In the treatment of bacterial infections of the upper respiratory tract, the leading role is played by antibiotic therapy, and determining the indications for its purpose, volume, and duration is a predictor of the success of the treatment. The effectiveness and adequacy of antibiotic therapy are determined by the timeliness and accuracy of differential diagnosis between viral and bacterial etiology of infection. The absence of a «gold standard» for differential diagnosis determines an increased interest in finding biomarkers that can solve this diagnostic problem, as well as formulating strategies for using antibacterial drugs based on the results of a quantitative assessment of serum biomarkers (biomarker-mediated antibacterial therapy). The article presents data from foreign literature on the results of studies and meta-analyses of the diagnostic value of C-reactive protein, procalcitonin, neopterin, and defensins to optimize biomarker-mediated antibacterial therapy for acute respiratory infections of the upper respiratory tract.
Voenno-medicinskij žurnal. 2020;341(4):41-47
pages 41-47 views

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Voenno-medicinskij žurnal. 2020;341(4):47
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Multiplex analysis systems: prospects for use in the diagnosis of infectious diseases

Nikitin M.Y., Katsalukha V.V., Shchelgachev V.V.


A review of the literature data of recent years on the problem of developing a new promising laboratory method - multiplex analysis is presented. Multiplex systems allow the simultaneous detection of several markers (antigens, antibodies, nucleic acids, etc.) in one sample without separation. A brief description of the leading technologies used in the development of various systems of multiplex analysis is given. Examples of the successful application of the method for the diagnosis of infectious diseases relevant for the military medical service are offered: the detection of arbovirus antigens, bacterial toxins, pathogens of the gastrointestinal and respiratory tract infections, and sexually transmitted diseases. The multiplex analysis was useful for identifying in one sample immunoglobulins of various classes and different specificities. It is shown that the new method can significantly increase the effectiveness of therapeutic measures.
Voenno-medicinskij žurnal. 2020;341(4):48-55
pages 48-55 views

Features of providing medical equipment to troops (forces) in the Arctic zone

Miroshnichenko Y.V., Kononov V.N., Golubenko R.A., Rodionov E.O., Mustaev O.Z., Fisun A.Y.


The article shows that the special medical and geographical conditions of the Arctic have a pronounced, mainly adverse effect on the methods of warfare, on the conduct of medical and evacuation measures, as well as on the provision of medical equipment and units of the Russian Armed Forces. The features of providing medicines and medical products in the Arctic zone are established. Measures to preserve the quality of drugs and medical devices in the Arctic are considered, the procedure for their use is determined, and the requirements for their transportation are established. Promising examples of the tent fund for the deployment of medical units in the Arctic are identified. The results of the analysis of the influence of the conditions of the Arctic zone of the Russian Federation on the need for units and military units of the Armed Forces in medical equipment are presented.
Voenno-medicinskij žurnal. 2020;341(4):56-61
pages 56-61 views

Implementation of the management concept of «lean healthcare» in medical organizations

Breusov A.V., Otstavnov S.S., Galik V.P., Orudzhev A.A.


The possibilities of introducing the management concept of «lean healthcare» in stationary and outpatient organizations are investigated. The main elements of lean healthcare are classified. Several specific measures are proposed for the implementation of lean healthcare in polyclinics and hospitals; the authors reduced them to several approaches depending on the source of application, urgency, and complexity. Based on the results of the study, a conclusion was drawn about the timeliness and feasibility of introducing lean healthcare in medical organizations.
Voenno-medicinskij žurnal. 2020;341(4):62-64
pages 62-64 views

The impact of a healthy lifestyle on the dental health of patients

Avetisyan A.Y., Grinin V.M.


The purpose of the work was to determine the degree of influence of HLS on the dental health of patients aged 35-44 years. According to the results of a sociological survey, two groups were formed: leading (No. 1, n=30) and non-leading (No. 2, n=34) healthy lifestyles. Significant differences were revealed: the prevalence of caries in group No. 2 was 100% (No. 1 - 76.7%), the indexes of the hygienic state of the oral cavity (5.2 versus 1.1) and the effectiveness of oral hygiene (1.8 versus 0.2). In group No. 2, only 5.9% of patients had a healthy state of periodontal disease, pathological periodontal pockets with a depth of 6 and > mm were three times greater in patients (8.8%) compared with group No. 1 (2.9%). Periodontic care was required for 94.1% of patients in group No. 2 (No. 1 - 72.1%). An adequate oral hygiene regimen (2 times a day) was detected in 93.3% of patients in group No. 1 and only 38.2% in group No. 2.
Voenno-medicinskij žurnal. 2020;341(4):64-66
pages 64-66 views

Evaluation of the effectiveness of antihypertensive therapy in patients with arterial hypertension and multifocal atherosclerosis

Kryukov E.V., Potekhin N.P., Fursov A.N., Zakharova E.G.


The effectiveness of antihypertensive therapy of patients with arterial hypertension was analyzed depending on the location of atherosclerotic vascular stenosis. Five comparison groups of 32 people each were arbitrarily formed. The average age of patients is 61.9±13.9 years. The condition for inclusion in the study was the presence of stenosis of the arterial bed from 40 to 70%. It was shown that the levels of blood pressure achieved against the background of antihypertensive therapy in the comparison groups significantly differed depending on the location of vascular stenosis. Recommendations are given for making target blood pressure levels.
Voenno-medicinskij žurnal. 2020;341(4):66-67
pages 66-67 views

Heart rate variability, dispersion mapping and pulse wave assessment in an expert assessment of flight personnel

Novikov E.M., Zhuravlev S.V., Ardashev V.N., Stebletsov S.V., Markin G.S., Nagovitsyn A.V., Antserova A.O., Lim V.S.


The results of a survey of flight personnel using the methods of heart rate variability and myocardial dispersion mapping with pulse wave analysis according to the Cardiovisor device are shown. This survey was performed on 30 military personnel who had undergone an army flight examination and were recognized fit for flight work. The control group consisted of patients with verified coronary angiography of coronary heart disease (n=10). The data obtained are analyzed; reference values of the conditional norm for the studied groups are developed.
Voenno-medicinskij žurnal. 2020;341(4):68-69
pages 68-69 views

The effectiveness of the health-resort treatment of patients with glaucoma in a low-mountain climatic resort

Antonov P.F., Sitnikov O.V., Tsyrulina D.R., Mareeva G.I.


The efficacy of electrosleep (15 people, 28 eyes, eight procedures) and endonasal nicotinic acid electrophoresis (26 people, 48 eyes, ten processes) on the course of glaucoma under conditions of low atmospheric pressure and carbon dioxide baths were studied. Intraocular pressure decreased by 31 eyes (64.6%) in those receiving endotasal nicotinic acid electrophoresis, in 16 eyes (57.1%) in those obtaining electric sleep, the field of view expanded by 46 (95.8%) and 14 (50 %) eyes. Positive dynamics in visual acuity and paracentral scotomas were noted. The best results in the spa treatment of glaucoma are achieved with the use of endonasal nicotinic acid electrophoresis and its combination with electric sleep.
Voenno-medicinskij žurnal. 2020;341(4):69-71
pages 69-71 views

Clinical case of successful treatment of abdominal sepsis in the early postoperative period in a soldier after splenectomy

Panov V.V., Derevyanko D.S., Polezhankin E.V., Myasnikov N.I.


A clinical case of the development of abdominal sepsis in a military man of military age against the background of postoperative hyposplenism is presented. The trigger mechanism was the development of postoperative intestinal paresis and secondary immunodeficiency as a manifestation of hyposрlenism, which ultimately led to bacterial translocation. Difficulties of diagnostics and features of treatment of a developing complication are indicated. The presented clinical case emphasizes the importance of the immune function of the spleen and the problem of studying infectious complications in patients with splenectomy.
Voenno-medicinskij žurnal. 2020;341(4):72-74
pages 72-74 views

Medical support for the aviation of the Air Force of the USSR during the Great Patriotic War

Vartbaronov R.A., Ushakov I.B., Zhdanko I.M., Khomenko M.N., Vovkodav V.S., Churilov Y.K.


The history of the creation and development of aviation medicine in the USSR, the medical support of the domestic Air Force during the Great Patriotic War (1941-1945), and in the first post-war years are highlighted. A significant decrease in the quality of medical support in 1941 due to a lack of qualified personnel, medical equipment, and organizational troubles was shown. As the situation on the fronts improved, from 1942, the medical support of aviation developed and reached a high level in 1944-1945. This was made possible thanks to the dedicated work of medical personnel, the close interconnections of science and practice, the sufficient work of doctors and commanders, as well as the creative development of new methods for organizing medical support for aviation in the Air Force.
Voenno-medicinskij žurnal. 2020;341(4):75-83
pages 75-83 views

On the history of the Omsk garrison military hospital

Kalmykov A.A., Uskov A.V., Burtasov A.G., Gudozhnikov M.G., Eselevich R.V.


The history of the Omsk Military Hospital, the oldest medical institution in Siberia, is presented. During its existence, the hospital has been reorganized several times. It is currently a modern military medical organization for the provision of qualified (including specialized) medical assistance to victims in peacetime and wartime. The article describes the main stages of the development of the hospital.
Voenno-medicinskij žurnal. 2020;341(4):84-88
pages 84-88 views

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Voenno-medicinskij žurnal. 2020;341(4):88
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Voenno-medicinskij žurnal. 2020;341(4):89-90
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Voenno-medicinskij žurnal. 2020;341(4):91-93
pages 91-93 views

Anniversary Scientific Conference dedicated to the 110th anniversary of aviation medicine

Lyutov V.V., Annenkov O.A.


A brief report is presented on a scientific conference dedicated to the 110th anniversary of aviation medicine in Russia, held by the S.М.Kirov Military Medical Academy based on branch No. 13 of the 442nd Military Clinical Hospital. They discussed the historical aspects of the formation and development of domestic aviation medicine, modern scientific and organizational problems, existing contradictions, as well as upcoming tasks and prospects for its growth. Actual issues and achievements of medical support of state aviation flights at present are considered. New conceptual approaches to solving the problems in maintaining health and professional longevity of flight personnel are proposed.
Voenno-medicinskij žurnal. 2020;341(4):94-96
pages 94-96 views

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