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Vol 341, No 3 (2020)


Modern approaches and technologies used in the medical support of military personnel in the Far North

Cherkashin D.V., Makiev R.G., Kirichenko P.Y., Marin A.I., Fisun A.Y., Alanichev A.E.


Modern technologies and organizational decisions are outlined aimed at improving the quality and accessibility of medical care to military personnel serving in the Far North. The conditions that determine the features of the provision of medical care in this climatic and geographic zone, the organization of telemedicine technologies, and air medical evacuation are analyzed. Promising areas for the development of modern technologies in military medicine for the conditions of the Arctic are identified, including the organization of close interaction with civilian transport services on the use of individual aircraft and sea vessels for the possible evacuation of wounded and injured, the creation of a precise routing of their routes, the expansion of the use of sanitary aircraft, the nature of infrastructure for their use, the centralization of the provision of specialized, including high-tech, medical assistance, and personnel deployed in the island area, the widespread adoption of digital technology for remote patient management.
Voenno-medicinskij žurnal. 2020;341(3):4-9
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Organizational and legal foundations of the military medical examination department in Saint-Petersburg

Petrova O.N., Karasaeva L.A., Chaplyuk A.L.


The organizational basis of the military medical examination is examined, the main directions of the work of the separate unit of the Main Center for Military Medical Expertise of the Ministry of Defense of the Russian Federation in the Western Military District - the Department of Military Medical Expertise of St. Petersburg are studied and analyzed. The functional responsibilities of the department’s medical specialists are highlighted and the main indicators of practical medical activity, the organization of methodological guidance in improving the quality of the examination and the treatment and diagnostic measures, the monitoring of the results of the citizens’ examination at the initial registration of citizens on military registration and military service, practical assistance are assessed. Military commissariats of the constituent entities of the Russian Federation on issues of military medical examination, work with citizens’ appeals are given, including a review of the conclusions of military medical commissions. The integrated activities of medical specialists of the military medical examination department require possession of regulatory, organizational, methodological and multidisciplinary knowledge.
Voenno-medicinskij žurnal. 2020;341(3):9-16
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Voenno-medicinskij žurnal. 2020;341(3):16
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Information technology in the work of trauma centers for the provision of specialized medical care to victims of road traffic accidents

Prikhodko A.N., Gurov A.N., Dementev I.M.


Within the framework of the Unified State Information System in Healthcare in the Moscow Region, an information system has been introduced that allows for statistical and economic analysis, modeling of the work of trauma centers to improve the quality of treatment, reduce the mortality rate of victims of road traffic accidents, unjustified financial losses, ensure timely provision of patients with functional prostheses after amputations of the limbs. In 2018, due to the preservation of the lives of victims in the trauma centers of medical organizations, the economic effect of 407 million rubles was obtained, which is 2.5 times more than in 2015, and the number of cases of dissatisfaction of patients with their work decreased by 33%.
Voenno-medicinskij žurnal. 2020;341(3):17-22
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The problem of eliminating open and intense pneumothorax at the advanced stages of medical evacuation and ways to solve it

Samokhvalov I.M., Golovko K.P., Chuprina A.P., Suprun T.Y., Zhirnova N.A., Denisov A.V., Komyagin S.E., Demchenko K.N., Vertii A.B.


Breast injuries are one of the leading causes of death in wounded, both in peacetime and in wartime. Improving the outcome of treatment for injured in the chest is associated with the early elimination of life-threatening consequences, in particular, open and intense pneumothorax, using high-tech medical devices. In the framework of the state defense order, the authors created a prototype kit for eliminating acute and open pneumothorax disposable sterile (paramedic) UD-02f. The purpose of the study was to study the frequency of open and severe pneumothorax in wounded chest patients, therapeutic measures, the outcome of their treatment at the stages of medical evacuation, testing, and evaluating the effectiveness of the prototype UD-02f kit. When eliminating stressful and open pneumothorax using a drainage catheter, a metal stylet needle, and an air valve from the UD-02f set, normalization of all indicators to values close to the initial costs occurs 30 minutes after the manipulation. A prototype of a sealing sticker with a valve eliminated open and intense pneumothorax by sealing the pleural cavity under conditions of moderate bleeding from the wound of the chest wall of the experimental animal.
Voenno-medicinskij žurnal. 2020;341(3):23-32
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The prevalence and prognostic significance of dyslipidemia and dysglycemia in military personnel

Gordienko A.V., Serdyukov D.Y., Zhirkov I.I., Fedorova A.S.


A prospective study was performed to assess the incidence of lipid metabolism disorders and the prevalence of primary atherosclerosis in male soldiers with early postprandial hyperglycemia. These patients showed more pronounced atherogenic changes in the lipid spectrum and a high incidence of prediabetes and type 2 diabetes mellitus, the most active progression of atherosclerosis, and a higher rate of liver fibrosis. The presence of one-hour hyperglycemia as an early marker of the development of prediabetes and type 2 diabetes mellitus must be evaluated in everyday clinical practice along with fasting glucose and two hours after a stress test.
Voenno-medicinskij žurnal. 2020;341(3):33-39
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Features of the pathogenesis, treatment, and prevention of atopic dermatitis in the military

Patrushev A.V., Samtsov A.V., Nikitin V.Y., Sukharev A.V., Ivanov A.M., Gumilevskaya O.P., Sukhina I.A.


Data on the prevalence and significance of atopic dermatitis for the armed forces of some countries are given. The results of our own studies of the blood cytokine profile of patients with atopic dermatitis in the acute stage, as well as the role of foci of chronic infection in the development of the disease are presented. An increase in the concentration of two cytokines (TNF-a and INF-a) was noted in a significant proportion of patients without any connection with the presence of foci of chronic infection, as well as a considerable increase in the level of interleukin IL-8 in the group of individuals with foci of chronic disease. The remediation of chronic infection is shown to be 2.9 times less likely to develop relapses.
Voenno-medicinskij žurnal. 2020;341(3):40-44
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Modern approaches to the treatment of neuroendocrine tumors

Krainyukov P.E., Simonenko A.V., Abashin V.G.


The article presents a methodological analysis of literature data reflecting modern approaches to the treatment of neuroendocrine tumors, including surgical treatment, metastatic surgery, chemotherapeutic treatment, and radiation therapy. The data on the chemo- and radioembolization of tumors, targeted chemotherapy, and radioisotope pharmacological drugs are presented. Based on the results obtained, a scheme has been developed for the complex therapy of neuroendocrine tumors, the main components of which are: surgical treatment (radical, palliative), drug therapy, including biotherapy; chemotherapy; combination therapy (biotherapy + chemotherapy); radiation therapy; concomitant therapy; symptomatic therapy.
Voenno-medicinskij žurnal. 2020;341(3):45-53
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Voenno-medicinskij žurnal. 2020;341(3):53
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On improving the prevention of tuberculosis in the Armed Forces

Muchaidze R.D., Zaretskii B.V., Dantsev V.V., Spitsyn M.G.


In the complex of measures for the prevention of tuberculosis, work with people exposed to factors of an increased risk of developing this disease is becoming increasingly important. Meanwhile, insufficient quality of medical examination of military personnel from the risk group for tuberculosis is noted; most of them are not detected and do not receive chemoprophylaxis. To increase the effectiveness of this work, new techniques are required, including the use of successful experience in the fight against tuberculosis in the armed forces of foreign countries. The article presents modern approaches to the organization and the conduct of anti-TB measures. Possible ways of using the positive experience of tuberculosis prevention in the US Army to improve anti-TB standards in the Armed Forces of the Russian Federation are identified.
Voenno-medicinskij žurnal. 2020;341(3):54-61
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Voenno-medicinskij žurnal. 2020;341(3):61
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The effectiveness of sanatorium medical and psychological rehabilitation of ship specialists with somatoform disorders after a long sea voyage

Ponomarenko G.N., Chermyanin S.V., Ishchuk V.N., Kovlen D.V., Adkhamov B.M., Ishchuk Y.V., Pronin V.D.


In long sea voyages, a set of unfavorable factors of professional activity affects seafarers, which leads to the development of maladaptive disorders and a decrease in professional longevity. The work aimed to evaluate the effectiveness of sanatorium medical and psychological rehabilitation carried out by sailors with a maladaptive disorder that developed after a long sea voyage. The mental, somatic state of health and physical performance of the seafarers were assessed upon admission and before discharge from the sanatorium. A syndromic-pathogenetic approach to the correction of maladaptation was used, and medical-psychological rehabilitation programs were proposed, which included physical therapy complexes, physical and psychotherapeutic methods of treatment. Significant restoration of the psychophysiological state, improvement of motivation for service activities, and recovery of reserve capabilities of the body of sailors were noted.
Voenno-medicinskij žurnal. 2020;341(3):62-67
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Enzyme-linked immunosorbent assay kit: design features and ways of modernization

Nikitin M.Y.


The article shows the advantages of membrane-filtration enzyme-linked immunosorbent assay (dot-IFA), implemented in the kit for point-based enzyme-linked immunosorbent assay KTIA-01.1. The equipment is designed to detect and identify antigens and toxins of especially dangerous infections pathogens in samples from the environment and from people, as well as serodiagnosis of the diseases they cause. Its composition is considered, main characteristics are given, an analysis of the results of testing the kit in the conditions of practical institutions of the Armed Forces medical service is presented. The advantage of the equipment is the ability to work with samples in stand-alone conditions and the simultaneous analysis of 20 samples for the presence of one pathogen or testing one example for eight desired antigens. A summary of comments on test systems and the composition of the kit is given, and directions for its modernization are proposed.
Voenno-medicinskij žurnal. 2020;341(3):68-72
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Features of the organization of therapeutic assistance to military personnel in the Arctic region

Khalimov Y.S., Agafonov P.V., Gaiduk S.V., Chekhovskikh Y.S., Fisun A.Y.


Due to the remoteness of the Arctic region, its harsh climatic and geographic characteristics, difficult sanitary and epidemiological situation, as well as the peculiarities of military labor, the contribution of therapeutic pathology to the structure of the incidence of personnel is significant. For the adequate provision of therapeutic care, it is justified to conduct such activities as the re-equipping of medical units and units beyond the state with the required medical specialists, medical equipment and property, the active use of the capabilities of the remote telemedicine consultations system, the establishment of interaction with medical organizations of civil health systems of the Arctic region, as well as with medical units of other ministries and departments performing tasks in the Arctic Region.
Voenno-medicinskij žurnal. 2020;341(3):73-75
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Reconstructive treatment of trophic insufficiency in wounded with the traumatic disease

Bulavin V.V., Yaroshenko V.P., Vorona A.A., Nikitin V.F., Remizov Y.I., Sorokin A.A.


A comprehensive clinical, laboratory, and somatometric study of 480 wounded with the traumatic disease, making it possible to establish the presence of malnutrition in 288 (60%) people, mainly with moderate and severe injuries. As the studies showed, in the wounded with malnutrition, a significant decrease in all somatometric indicators, the presence of anemia, an increase in the number of leukocytes, erythrocyte sedimentation rate, aminotransferase activity, impaired electrolyte metabolism, and a decrease in total blood protein were revealed. The inclusion of the Nutridrink balanced nutritional mixture in the complex treatment of the wounded helps to restore these indicators and improve the general condition of the injured.
Voenno-medicinskij žurnal. 2020;341(3):76-78
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Voenno-medicinskij žurnal. 2020;341(3):78
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Heads of the department (course) of military and military medical disciplines (organization and tactics of medical service) of the Military Medical Academy

Kulnev S.V., Vislov A.V., Ivakov Y.M.


The history of the department of organization and tactics of medical service (formerly - the department of military and military sanitary disciplines) within the walls of the Kirov Military Medical Academy is inextricably linked not only with the general history of the academy but also with the main stages of the construction of the medical service of the USSR Armed Forces and the Russian Federation, with the development of the theory and practice of military medicine. The article is dedicated to the heads of the department (course), whose efforts created the methodological and scientific center of the medical service of the Armed Forces to develop the most pressing organizational problems of military medicine.
Voenno-medicinskij žurnal. 2020;341(3):79-83
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Guardian angels in white coats (feats of physicians of the defense of Sevastopol in 1941-1942)

Murynin V.A., Zubarev A.A.


The article describes the exhibition at the 35th Coastal Battery Museum and Memorial Complex in Sevastopol. The exposition, created based on the funds of the National Museum of the 1472th Naval Clinical Hospital and the 35th Coastal Battery Historical and Memorial Complex, presents the fate of 52 physicians - defenders of the hero-city, whose main «weapon» was kind and sensitive heart, skillful hands and a desire to save human life at any cost.
Voenno-medicinskij žurnal. 2020;341(3):84-86
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On health services for railway workers during the Great Patriotic War

Zelenskaya Y.N.


Based on the analysis of documents from the funds of the central and regional archives, memoirs, periodical press materials, the article examines the state of medical care for USSR railway workers during the Great Patriotic War using the example of the front-line Kirov Railway. The focus is on the provision of medical and preventive care, protection, and improvement of the working conditions of railway workers. Extreme working conditions, labor intensification, housing, food and clothing problems caused by the war, non-observance of sanitary and hygienic standards had a negative impact on the state of health and working capacity of railway workers. During the Great Patriotic War, cases of violation of sanitary-hygienic and sanitary-anti-epidemic rules and norms were recorded on the Kirov Railway, the result of which was the creation of prerequisites for the spread of dysentery and pediculosis. Inadequate and unbalanced nutrition led to the emergence of diseases of dystrophy and scurvy. Failure to comply with safety and labor regulations contributed to the growth of injuries and accidents in the performance of professional duties on the railway.
Voenno-medicinskij žurnal. 2020;341(3):87-92
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Voenno-medicinskij žurnal. 2020;341(3):92
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Voenno-medicinskij žurnal. 2020;341(3):93-94
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Experience in the collection of traumatologists, orthopedists and surgeons of military medical organizations of the Southern Military District

Khominets V.V., Brizhan L.K.


A report is presented on the holding of a thematic collection of orthopedic traumatologists and surgeons of the military medical organizations of the Southern Military District based on the 1602nd Military Clinical Hospital of the Ministry of Defense of the Russian Federation, devoted to topical issues of military traumatology. The purpose of the collection was to improve the knowledge of orthopedic traumatologists and military surgeons of the military medical organizations of the military district on the treatment of victims with combat injuries of the extremities, as well as the principles of surgical treatment of bone fractures and the acquisition of practical skills for their application in everyday work in a military hospital.
Voenno-medicinskij žurnal. 2020;341(3):95-96
pages 95-96 views

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