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Vol 341, No 7 (2020)


The problem of sudden cardiac death in the Armed Forces of the Russian Federation

Patsenko M.B., Tyrenko V.V., Ovchinnikov Y.V., Prokhorchik A.A., Kachnov V.A.


The aim of the work was an in-depth analysis of the prevalence of deaths from cardiovascular diseases and sudden cardiac death in military personnel of the Ministry of Defense. The structure of the causes of its development, the distribution of cases of sudden cardiac death by age groups of military personnel, and places of its occurrence are given. It was shown that the leading cause of death was the development of sudden cardiac death. Among the causes of sudden cardiac death, ion channel diseases (47.8%) and coronary heart disease (18%) predominate. More often, it occurs in military personnel under 40 years old (80.8%). Most cases of sudden cardiac death (71.1%) occur outside of work hours.
Voenno-medicinskij žurnal. 2020;341(7):4-14
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Voenno-medicinskij žurnal. 2020;341(7):14
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The effectiveness of intraaortic balloon counter - pulsation used during coronary artery bypass grafting in patients with severe chronic heart failure of ischemic origin

Khubulava G.G., Sukharev A.E., Kravchuk V.N., Volkov A.M., Lyubimov A.I., Knyazev E.A., Kusai A.S., Romanovskii D.Y., Biryukov A.V., Zvoznikov V.I.


The materials of a retrospective analysis of the results of the surgical treatment of 133 patients with severe chronic heart failure of ischemic genesis who underwent coronary bypass surgery are presented. Three groups of patients were distinguished depending on the method of performing myocardial revascularization - on a working heart, in conditions of cardiopulmonary bypass and cardioplegia, on a working heart in terms of parallel cardiopulmonary bypass. Intraaortic balloon counterpulsation has been used both for prophylactic purposes since the preoperative period and for perioperative correction of acute heart failure. It has been established that the use of this type of mechanical circulation support in the presence of preoperative risk factors cannot ensure the safe execution of coronary artery bypass grafting on a working heart. The preventive use of aortic counterpulsation during coronary artery bypass grafting under conditions of planned cardiopulmonary bypass allows reducing the risk of acute heart failure during the perioperative period. If it is impossible to use it in «high - risk» patients, it should be taken into account that operating on a working heart with cardiopulmonary bypass causes a likelihood of developing heart failure 6.3 times less than with myocardial revascularization under cardiopulmonary bypass and cardioplegia.
Voenno-medicinskij žurnal. 2020;341(7):15-21
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The composition of muramyl peptides, including the residue of meso - diaminopimelic acid, in the treatment of purulent infections of soft tissues

Kirshina O.V., Tokarev A.V., Lagereva Y.G., Novikova A.V., Fedenko E.S., Konovalov P.V., Lobut O.A., Popilyuk S.F., Kalyuzhin O.V., Nurtazina A.Y.


The clinical and immunomodulatory efficacy of the composition of three muramyl peptides containing the remainder of meso - diaminopimelic acid (polyuramyl) in the treatment of purulent - inflammatory diseases of soft tissues was evaluated. 30 patients included in the study (18-65 years old) with soft tissue infections, mainly abscesses, and phlegmon, without a pronounced concomitant pathology, were divided into 2 groups, equal in number and comparable in age, assigned sex, and primary clinical and laboratory characteristics. In the comparison group, patients received standard treatment; in the leading group, besides, intramuscularly polymuramil 200 mg daily for 5 days. In all patients, on the 1st and 5th days, the linear dimensions of the wound were measured, and blood samples were taken for hematological and immunological studies. The timing of the appearance of granulations was monitored daily. The inclusion of polyuramil in the complex treatment of patients increased the degree of regression of the depth and area of the wound. It accelerated the appearance of granulations, caused changes in several hematological and immunological parameters reflecting the stimulation of thrombopoiesis and leukopoiesis, and an increase in the effectiveness of anti - infection protection.
Voenno-medicinskij žurnal. 2020;341(7):21-29
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Mathematical prediction of aspiration doses of microbial aerosols

Vasilenko A.Z., Vorobeichikov E.V., Komissarov N.V.


The article discusses two methodological approaches to predicting aspiration doses of microbial aerosols - deterministic and probabilistic. It is shown that at low concentrations of microbial aerosol, the deterministic method of solving the problem gives rough and overestimated estimates of the aspiration doses of microorganisms. Under similar conditions, the application of the probabilistic approach demonstrates a slower dynamic of the accumulation of microbes in the respiratory tract, associated with the uneven spatio - temporal distribution of microbial aerosol particles in the air and the identity of the human respiratory cycles. This is relevant for predicting the aerogenic infection of recipients by microorganisms having low infectious doses (single cells), as well as for the process of indicating low concentrations of microbial aerosol in space - time coordinates.
Voenno-medicinskij žurnal. 2020;341(7):30-34
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On the adaptation of cadets of military schools and the prevention of respiratory diseases

Rakhmanov R.S., Bogomolova E.S., Tarasov A.V.


An assessment of the incidence rate of respiratory diseases among cadets of two military schools located in the Kaliningrad Region, in which newcomers from other regions of Russia accounted for 42.3 and 86.8%. Higher rates of acute respiratory infections, influenza, and community - acquired pneumonia among visiting cadets are associated with their low acclimatization to the weather and climate conditions of the Baltic states. A significant excess of the incidence of all first - year cadets over that among senior cadets indicates the influence of the complex of educational requirements on their health. In the observed universities, different durations (in years) of the excess incidence among cadets with shorter periods of study over this indicator among cadets of recent courses were noted. The prevalence of morbidity in the second military collective is due to a more pronounced effect of environmental factors. The revealed differences in the incidence of respiratory diseases in courses of study and cohorts of cadets should be considered when organizing preventive measures.
Voenno-medicinskij žurnal. 2020;341(7):35-40
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The relationship of adaptability and typological personality characteristics in military personnel with disorders of the neurotic spectrum

Slyusarev A.S., Kobzov V.A., Murzina-Toloraya O.V., Kozlov M.Y.


Based on the study of the relationship between various psychological characteristics and adaptability in military personnel, the article identifies personality traits and their constellations that are prognostically significant for early diagnosis of an adaptation disorder at the stage of the preneurotic state. A probabilistic psychological portrait of a person who is prone to prolong neurotic reactions in conditions of protracted psychoemotional stress is compiled. The prevalence of such psychological defenses as regression, replacement, compensation, many experiences of emotional discomfort, external locus of control, and the inability to accept oneself is revealed. It is shown that a maladaptive soldier is much more likely to have hysterical, schizoid, psychasthenic (anxious - suspicious), or hypotymic (depressive) individual typological features.
Voenno-medicinskij žurnal. 2020;341(7):40-47
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Voenno-medicinskij žurnal. 2020;341(7):47
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Substantiation of norms for medical equipment supplement to military health - resort organizations based on project - oriented approaches

Miroshnichenko Y.V., Stavila A.G., Dolgikh S.V., Rodionov E.O., Kostenko N.L.


One of the mechanisms to increase the efficiency of the health - resort organizations of the Ministry of Defense of Russia is the scientifically based rationing of medical property to ensure them. The article presents the factors affecting the need for the therapeutic property of health - resort organizations, proposes modern approaches to rationing medicines, medical devices, medical equipment, and equipment for them. The algorithm for the development of a new standardization system is determined, and the proposals on its implementation in the norms for supplying medical property to health - resort organizations of the Ministry of Defense are substantiated. The developed rationing procedure and the structure of the standards for providing medical equipment to military health resorts make it possible to determine its nomenclature and quantitative indicators.
Voenno-medicinskij žurnal. 2020;341(7):48-53
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International experience in the use of personal data of patients in telemedicine consultations

Kalachev O.V., Sushilnikov I.S.


The results of the analysis of domestic and foreign regulatory legal acts in the field of personal data and medical confidentiality are presented. The problems of legal regulation in the regimes of personal data and medical privacy were revealed: reduced responsibility of the operator of personal data; it is difficult to obtain the written consent of the patient in the implementation of telemedicine; there are no clear boundaries for applying exceptions to the written permission of the patient to the processing of personal data, which may lead to violations of the rights and legitimate interests of patients the ratio of legal regimes of medical confidentiality and personal data remains blurred. One possible solution is to prioritize special legislation on medical privacy.
Voenno-medicinskij žurnal. 2020;341(7):54-56
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Prospects for improving expert approaches to determining suitability for military service, considering the provisions of the International Classification of Diseases of the eleventh revision

Datsko A.V., Potekhin N.P., Brovkin S.G., Ignatov Y.G., Yumanov A.P.


The practice of applying the Schedule of Diseases (Section II of the Appendix to the Regulation on Military Medical Examination, approved by Decree of the Government of the Russian Federation dated 04.07.2013 No. 565) revealed several problematic issues that determine the need for its processing, including taking into account the adoption of the International Statistical Classification of Diseases and health problems, eleventh revision. An option is considered to solve the problem of processing the Schedule of Diseases following the headings of ICD-11 by carrying out a complex of scientific research.
Voenno-medicinskij žurnal. 2020;341(7):56-58
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Algorithm for detecting carbohydrate metabolic disorders in personnel officers

Popov A.P., Didenko O.I., Grabarnik E.A., Kruglova M.A., Sibagatova E.G.


To increase the efficiency of screening for carbohydrate metabolism among staff officers, a comprehensive survey of 2523 people aged 20 to 59 years was carried out, including a review using the Diabetes Risk Assessment Scale (FINDRISC). The expediency of studying the state of carbohydrate metabolism among officers under 40 years of age is substantiated.
Voenno-medicinskij žurnal. 2020;341(7):58-61
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Efficiency the use by military specialists of visually intense labor of biologically active additives that improve vision

Ovechkin I.G., Yudin V.E., Kosukhin E.S., Budko A.A., Belikova E.I., Kozhukhov A.A., Shakula A.V.


It has been determined that the use by a military specialist of visually intense work of biologically active additives that improve eyesight can be recommended in two main directions. The first (prophylactic) - is associated with eliminating the deficiency of vital nutrients, adapting the body to harmful environmental factors, or pre - training for intense visual stress. The second (supporting) - in the treatment of the disease as an adjuvant to the medicine, including to reduce the doses of drugs that have side effects.
Voenno-medicinskij žurnal. 2020;341(7):61-63
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On X-ray studies of the abdomen in conditions the chambers

Alekseeva O.M., Vasilev A.Y., Kryukov E.V., Troyan V.N., Lezhnev D.A., Egorova E.A., Petrovskaya V.V., Smyslenova M.V., Truten V.P.


Based on the study of 93 radiographs, the results of radiographic examinations of the abdominal organs performed in the wards and resuscitation rooms of multidisciplinary hospitals, as well as the validity of appointments and diagnostic effectiveness, are analyzed. Indications for the implementation of these studies are formulated, and the features of their conduct are discussed, which will allow performing diagnostic x - ray procedures in the wards more efficiently.
Voenno-medicinskij žurnal. 2020;341(7):64-66
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A rare case of ventral extradural arachnoid cyst in the cervical spine in combination with type I neurofibromatosis

Churilov Y.K., Richei I.I., Gorbunov A.V., Myasoedova O.O., Lisenkov K.A., Glukhov S.G., Kuleshov D.Y., Ishunin I.E., Vovkodav O.O., Moskovskikh T.A.


Presented are the materials of the clinical observation of a rare case of ventral extradural arachnoid cyst in the cervical spine in combination with type I neurofibromatosis. A contract serviceman, 33 years old, was diagnosed with type I neurofibromatosis at the next medical examination in 2010. In 2019, when radiography of the cervical spine revealed left - sided scoliosis of the second degree with deformation of 3 - 6 vertebral bodies, with MRI of the cervical spine, pronounced expansion of the spinal canal and deformation of the vertebral bodies at the level of C2 - Th1 with cystic protrusions through the intervertebral openings (C3 - C6 vertebrae) with a total maximum size of up to 50ґ55ґ113 mm, spreading paravertebrally, mainly on the left.
Voenno-medicinskij žurnal. 2020;341(7):66-68
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Voenno-medicinskij žurnal. 2020;341(7):68
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The 442nd Military Clinical Hospital of the Ministry of Defense of Russia celebrates the 185th anniversary

Lyutov V.V.


Over the 185-year history, the 442nd Military Clinical Hospital has made a significant contribution to the development of national health care. Prominent medical scientists of the 19th - 20th centuries worked in it. V.M.Bekhterev, N.V.Sklifosovsky, R.R.Vreden, P.A.Kupriyanov, N.N.Petrov and others. Today in the hospital, four doctors and 26 candidates of medical sciences, ten honored doctors of the Russian Federation, more than 1,500 doctors, and nurses have the highest and first qualification categories. The hospital is one of the best in the medical service of the Western Military District. The team has made positive progress in improving combat skills and field training. Currently, a phased reconstruction and capital construction plan for the main base of the hospital is being successfully implemented.
Voenno-medicinskij žurnal. 2020;341(7):69-73
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Prominent figure in aviation and space medicine (On the 90th anniversary of the birth of S.A.Bugrov)

Ushakov I.B., Bednenko V.S., Vartbaronov R.A., Zhdanko I.M.


The article presents a review of the multilateral scientific and practical activities of Professor Major General of the Medical Service Stanislav Alekseevich Bugrov (1930-2003). His significant contribution to topical research of the State Research Institute of Aviation and Space Medicine of the USSR Ministry of Defense was noted as a tester in the conditions of the first long - term sound chamber isolation of the crew, in field tests of methods and means of increasing the body’s resistance to the effects of aviation and space flight factors, and the development of promising compositions wearable emergency stocks for various climatic and geographical areas, physiological and hygienic justification of pit astronauts and flight crews, water supply, implementation of the obtained results in human - crewed flights at the Salyut - 3, Salyut - 4, Salyut - 5 orbital stations, and subsequent domestic and international space expeditions. S.A.Bugrov has always shown an extraordinary talent as a leader, made a significant contribution to the development of problems of medical control of flight personnel, the creation, and improvement of the life support system for crews of aircraft. Becoming the head of the Air Force Aerospace Medicine Service in 1988, he actively carried out the re - equipment of medical facilities with modern diagnostic and therapeutic equipment, did a lot of work as a co - chair of the Main Medical Commission for the selection of astronauts, chairman of the State Commission for the Preparation and Launch of Cosmos Biosatellites, co - chair of the subgroup «Space Medicine» of the mixed Soviet - American working group on the study of outer space.
Voenno-medicinskij žurnal. 2020;341(7):74-78
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The formation and development of air ambulance in the USSR in the 1920-1930s

Sokolov V.A., Varfolomeev I.V., Butrin Y.L., Tsvetkov D.S.


An analysis of the primary sources devoted to the formation of air ambulance in the USSR in the 1920-the 1930s revealed several common patterns with world experience in the development of evacuation air vehicles. At the same time, domestic specialists found and implemented mostly original solutions to the multifaceted problem of accelerating the delivery of people in need from remote areas to specialized medical institutions. Practical experience of the 1920s testified to the feasibility of creating unique designs of ambulance aircraft. In a country with reviving aviation industry and a young engineering and technical staff, the implementation of such a difficult task was made possible thanks to the active support and work of public organizations and government agencies. A fundamentally new solution in world medical practice of that time was the creation in the USSR of a network of ambulance stations. The delivery by airplanes to remote areas of the country of medical workers who performed various therapeutic, diagnostic, preventive, and anti - epidemic tasks there significantly increased the quality of medical care provided to the population.
Voenno-medicinskij žurnal. 2020;341(7):78-87
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Voenno-medicinskij žurnal. 2020;341(7):87
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Voenno-medicinskij žurnal. 2020;341(7):88-89
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Voenno-medicinskij žurnal. 2020;341(7):90-91
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Conference on Military Radiology, dedicated to the 90th anniversary of the birth of V.G.Vladimirov

Chepur S.V., Ivchenko E.V., Seleznev A.B., Drachev I.S., Ivanchenko A.V., Bozhedomova E.R.


The article presents results of the scientific - practical conference «Military Radiology: Results and Prospects» dedicated to the 90th birthday of V.G.Vladimirov, held in March 2020 at the State Scientific Research Testing Institute of Military Medicine of the Ministry of Defense of the Russian Federation. During the conference, topical areas of military radiology were discussed, such as improving the biological dosimetry system, developing and increasing the information content of methods and methods for diagnosing the severity of radiation injuries and retrospectively assessing radiation doses, developing new highly effective means of preventing and treating radiation injuries, and searching for new mechanisms for radioprotective effects of radiation remedies among well - known radioprotectors, updating the solution of scientific and practical issues medicated radiation protection at the level of inter - agency cooperation, conferences and round table discussions on practical matters of medical support in emergencies radiation character.
Voenno-medicinskij žurnal. 2020;341(7):92-96
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