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Vol 341, No 10 (2020)


Organization of drug provision for military personnel undergoing medical and psychological rehabilitation in health resort organizations of the Ministry of Defense

Miroshnichenko Y.V., Dolgikh S.V., Stavila A.G., Rodionov E.O., Skibo I.A., Kirsanova A.A.


It is shown that drugs are an integral and most important component of medical and psychological rehabilitation of service members in military health resort organizations. It has been found that the use of drugs, along with other treatment methods, helps improve the mental status of patients, prevent the development of neurotic reactions, social maladjustment, and several other pathological conditions. The article presents the characteristics of medicines in the norm for the supply of medical equipment for medical and psychological rehabilitation in military health resorts.
Voenno-medicinskij žurnal. 2020;341(10):4-10
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Electrophysiological methods for the diagnosis of disorders of neuromuscular transmission in acute poisoning with organophosphorus compounds

Tyunin M.A., Ilinskii N.S., Gogolevskii A.S., Kruchinin E.G., Gladkikh V.D., Matseichik V.A., Matrosova M.O.


The article presents the results of an experimental study of neuromuscular transmission disorders caused by acute poisoning with a model organophosphorus compound dimethoate. In order to diagnose synaptic transmission disorders, methods of single and rhythmic stimulation electromyography were applied. It was found that the most characteristic and early EMG signs of acute poisoning with organophosphorus compounds are repeated M - responses and the phenomenon of decrement - increment during rhythmic stimulation with a frequency of 10-30 Hz. The diagnostic sensitivity of high - frequency rhythmic stimulation is higher than the routine technique used at a stimulation frequency of 3 Hz. Organophosphorus - induced synaptic transmission disorders are due to cholinergic hyperreactivity and prolonged activation of H - cholinergic receptors. The results of this study can be used both in the diagnosis of poisoning by unknown poisons, and to establish the fact of violation of neuromuscular transmission and assess its severity during intoxication with organophosphorus compounds.
Voenno-medicinskij žurnal. 2020;341(10):11-19
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Voenno-medicinskij žurnal. 2020;341(10):19
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Possibilities of ultrasound examination for the diagnosis of structural changes in the kidneys at the stage of providing specialized medical care

Sergoventsev A.A., Rybchinskii S.S., Mashkov T.N., Bakasova A.V.


The study aimed to assess the correlation of ultrasound examination results with the data of computed and magnetic resonance imaging in the diagnosis of structural changes in the kidneys in a military clinical hospital. One hundred twenty - one patients were examined, including 35 women aged 68.3±12.8 years and 86 men aged 68.5±14 years. A high and very high connection (rЈ0.7) was found in neoplasms, calculi and simple (type I according to Bosniak) cysts as a result of an unambiguous interpretation of the echographic picture based on a characteristic sign of structural changes: hyperechoic - calculus, anechoic - cyst, vascular weakly echogenic against the background of the parenchyma - a neoplasm. With complicated cysts (types II-III according to Bosniak), peripelvic cysts with and without expansion of the cavity system, moderate and noticeable correlations were established (r>0.4 and r<0.69). The proposed scoring of the diagnostics’ complexity is aimed at leveling the often - unjustified expectations of the accuracy of ultrasound results by attending physicians.
Voenno-medicinskij žurnal. 2020;341(10):20-26
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The use of transforaminal endoscopic discectomy and foraminoplasty after transforaminal fusion in the lumbar spine

Lapin V.I., Kryukov E.V., Kudryakov S.A., Aslanov R.A.


A retrospective study (2015-2018) included seven patients after transforaminal fusion in the lumbar spine with pain in the back and legs with confirmed foraminal stenosis and/or residual/recurrent disc herniation or pain syndrome, decreasing or stopping by anti - inflammatory therapy. The work aimed to evaluate the effectiveness of revision transforaminal endoscopic foraminoplasty in such patients. Endoscopic foraminoplasty was performed either to decompress the foraminal foramen in the event of stenosis, or for endoscopic visual examination of compressed intersecting and exiting nerve roots in the armpit. The average follow - up period was 25.8 months; the minimum was ten months. Results were assessed on the Macnab Subjective Rating Scale (Macnab), Visual Analogue Scale (VAS), and Oswestry Validity Index (ODI). The mean VAS significantly (p<0.005) improved from 7.8 to 2.7. There were no adverse outcomes on the McNab scale. The rate of excellent and functional results was 71.4% overall. No reoperations were required. There were no intra - and postoperative complications. In two cases, there was a burning sensation in the operated side’s heel area, which regressed after a week on the background of anti - inflammatory therapy.
Voenno-medicinskij žurnal. 2020;341(10):27-33
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Correction of immune reactivity in cardiac surgery patients with deep sternal infection

Potapov V.A., Kokhan E.P., Asanov O.N., Abdulaev K.R., Musailov V.A.


The study was carried out in the period from 2010 to 2019 in 88 patients with sternomediastinitis after cardiac surgery (mean age 63.4±one year). Depending on the treatment tactics, the patients were divided into three groups: group 1 (comparisons, n=48) - the «traditional» method of treatment was used; group 2 (primary, n=20) - the technique of local negative pressure (vacuum therapy) was used as monotherapy; group 3 (primary, n=20) - vacuum therapy in combination with bacteriophages. In 10 patients from each group, randomly selected on the 3rd, 7th, and 14th days, venous blood sampling was performed to determine the dynamics of indicators of the immune status. Upon admission, all patients showed a decrease in the immunoregulatory index to 0.6±0.14 units (half the norm). In group 3, average indicators of cellular immunity were observed already from the 3rd day, the immunoregulatory index on the 7th day was 1.5 units. In groups 1 and 2 - mild compensatory dynamics, imbalance of CD4 and CD8 subpopulations of T-lymphocytes, immunosuppression. On the 14th day, the T- and B-lymphatic link cells, NK-cells, were at the lower limit of the norm, and the immunoregulatory index (1.2 units) did not reach optimal values. On the 7th and 14th days, normal immunological parameters were significantly more often detected in group 2 (p=0.05), on the 3rd, 7th, and 14th days - in group 3 (p=0.05).
Voenno-medicinskij žurnal. 2020;341(10):33-39
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Is early ventricular repolarization of the heart still a normal option?

Bobrov A.L., Gordienko A.V.


The review article is devoted to the diagnosis and clinical significance of the phenomenon and syndrome of early ventricular repolarization of the heart. Early repolarization syndrome is a clinical condition involving a combination of the phenomenon of early repolarization and polymorphic ventricular tachycardia, ventricular fibrillation, and/or sudden cardiac death in individuals without structural heart disease. Twelve years ago, the phenomenon was recognized as an unambiguous version of the norm. However, several multicenter studies have shown that the phenomenon is associated with an increased risk of sudden cardiac death. In patients with the syndrome and individuals with the phenomenon of early repolarization against the background of a burdened family history, therapeutic measures are required.
Voenno-medicinskij žurnal. 2020;341(10):40-44
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Minimally invasive methods of lung resection with video support in patients with tuberculoma

Polyanskii V.K.


In modern thoracic surgery, minimally invasive methods of surgical treatment using video thoracoscopy are widely used. Video thoracoscopic resections of a small volume are performed, «large» pulmonary resections, which are commonly understood as forehead, biloba, and pneumonectomy, are performed only in the form of video - assisted interventions. We used video - assisted lung resections with video support for tuberculosis in 96 patients aged 18-54 years, all under general anesthesia with separate mechanical ventilation. The results confirmed that minimally invasive accesses under the control of video thoracoscopy in patients with pulmonary tuberculosis contribute to a reduction in the morbidity of surgical interventions, the duration of postoperative rehabilitation, and a significant decrease in the period of inpatient treatment and its cost.
Voenno-medicinskij žurnal. 2020;341(10):45-50
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Treatment of children with pathology of the musculoskeletal system in combination with cerebral palsy in a military children’s sanatorium

Ponomarenko Y.N., Deryabin A.V., Nen’ko A.M., Vlasenko S.V., Khashchuk A.V.


The reconstructive treatment of 825 children with spastic forms of cerebral palsy was evaluated, including 148 patients receiving conservative orthopedic treatment, 677 received orthopedic surgical treatment. Five main surgical methods were used to correct joint contractures and deformities of the limbs: tendon - muscle plastic, bone - joint plastic operations, correction by external fixation devices, alloplasty using tendon and bone bioimplants, selective myofasciotomy. All patients in the treatment used the healing factors of the resort. Long - term results were studied in the period from 1.5 to 8 years after treatment. A good result was observed in 61.2% of patients (achieved a higher level of physical activity, acquired new everyday skills), satisfactory - in 18.4% (partial loss of the achieved correction of contractures), unsatisfactory - in 11.4% of patients (with the initial 5 the level of motor impairment, gross cognitive defect, ongoing hyperkinetic syndrome).
Voenno-medicinskij žurnal. 2020;341(10):50-57
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Voenno-medicinskij žurnal. 2020;341(10):57
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The dependence of the mental and physical performance of the pilot on the tolerance of hypobaric hypoxia, considering the individual psychological characteristics of the personality

Isaenkov V.E., Dzankisov R.A., Baryshov D.V., Sinelnikov S.N.


Изучено влияние переносимости гипобарической гипоксии на умственную и физическую работоспособность военнослужащих летного состава оперативно - тактической авиации с учетом индивидуальных психологических особенностей. Оценивались показатели сатурации артериальной крови, физическая работоспособность (индекс Гарвардского степ - теста), умственная работоспособность (методика «счет - письмо») и индивидуальные психологические особенности личности. Установлено, что среди лиц с высокой переносимостью гипоксии чаще встречаются экстраверты, лица с низкой степенью нейротизма и личностной тревожности. У них более выражены лидерские качества и социабельность. Среди лиц с низкой переносимостью гипоксии чаще встречаются интроверты. В данной группе более высокий уровень личностной тревожности и нейротизма, также более выражена конформность. При оценке физической и умственной работоспособности выявлено, что когнитивные показатели в процессе гипоксического воздействия в группе лиц с высокой переносимостью гипоксии не претерпевают значительных ухудшений, в отличие от группы с низкой переносимостью, в которой отмечается снижение количества решенных примеров по методике «счет - письмо» и увеличение количества совершаемых ошибок по сравнению с фоновыми данными. Также у них отмечается более низкая физическая работоспособность после гипоксического воздействия.
Voenno-medicinskij žurnal. 2020;341(10):58-62
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Experience in the treatment of a severe form of coronavirus infection COVID-19 in the central military hospital

Krainyukov P.E., Demyanenko A.V., Afonaskov O.V., Gudantov R.B., Popov A.V., Dieva T.V.


The article presents the materials on the 18 days treatment of a 72 - year - old patient who had been for 18 days at the P.V.Mandryka Central Military Clinical Hospital with a severe form of coronavirus infection COVID - 19, complicated by bilateral polysegmental pneumonia. Comorbid pathology: type 2 diabetes mellitus, subcompensation of carbohydrate metabolism; cardiac ischemia; exertional angina, II functional class; atherosclerotic cardiosclerosis; paroxysmal supraventricular tachycardia; chronic heart failure 2A degree; hypertension stage 2, arterial hypertension - 1, risk 4. The patient was admitted in a stable condition without signs of respiratory failure. During the day, there was a lightning - fast deterioration requiring a transfer to the lungs’ artificial ventilation, followed by ventilation in the prone position. On the 8th day, extubation was performed. On the 18th day, he was discharged in a satisfactory condition.
Voenno-medicinskij žurnal. 2020;341(10):63-66
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Regulation of the work of medical personnel in a single medical information - analytical system

Andreev V.G., Medvedeva O.V., Afonina N.A., Dmitrieva M.N., Dorokhov V.A.


The timing method determined the time of admission of the patient and filling out the primary medical documentation in two groups: a psychiatrist and a nurse (n=30); general practitioner and nurse (n=30). A total of 120 people were included in the study, performing outpatient admissions in classrooms equipped with automated workstations for the doctor and nurse. A statistically significant reduction in the time of outpatient admission was revealed in the case of an active tandem of a doctor and a nurse with additional responsibilities for maintaining an electronic map - from 29.53±1.44 and 31.1±1.35 to 13.9±0.48 and 14.1±0.50 min, respectively, for the group. Reducing the time for primary documentation by the doctor will improve the quality of the provision of medical services to the patient by increasing the patient’s direct contact with the doctor.
Voenno-medicinskij žurnal. 2020;341(10):66-68
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The use of reflexology in the complex treatment of military personnel with special working conditions

Kuvshinov K.E., Khritinin D.F., Tyan V.N., Karakozova M.G., Karakozov A.G., Levchenko O.B., Molodova A.I.


The article describes the possibilities of the reflexology room for the planned treatment of service members under contract and conscription, reserve and retired, members of families of military personnel, and patients under voluntary medical insurance programs and the provision of paid services. A vast arsenal of reflexotherapy methods has been introduced into the practice of complex treatment of service members with exceptional working conditions, which achieves a stable positive effect in 98% of cases. The relief of neuropsychic stress (neurotic reactions, asthenic states) is noted in 95%, and the normalization of the psychophysiological state of service members - in 99% of cases.
Voenno-medicinskij žurnal. 2020;341(10):68-70
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Bilateral testicular microlithiasis in a young serviceman with seminoma of the left testicle

Protoshchak V.V., Sivakov A.A., Kushnirenko N.P., Babkin P.A., Lazutkin M.V., Alent’ev S.A., Kharitonov N.N., Karandashov V.K., Gozalishvili S.M., Kushnirenko K.N.


Testicular microlithiasis is a disease in which, according to the data of radiological research, multiple intra - testicular calcifications are detected. The diagnostic criterion is the presence of five or more hyperechoic inclusions in the testicular parenchyma, each not exceeding 3 mm in size. Recently, a lot of attention has been paid to testicular microlitasis, since more and more data are accumulating, indicating that pathology can serve as a predictor of testicular malignant neoplasms. To detect neoplasms early, patients diagnosed with testicular microlithiasis should undergo an annual ultrasound examination of the testicles and determine the concentration of tumor markers.
Voenno-medicinskij žurnal. 2020;341(10):71-73
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Quality of life as a criterion for the effectiveness of osteopathic treatment of conscripts with autonomic dysfunction syndrome

Matvienko V.V., Buchnov A.D., Egorova I.A., Lupanov A.I., Yudin V.E., Kosukhin E.S., Kharisov A.M.


The functional state of the organism of 30 conscripts aged 19-20 with autonomic dysfunction syndrome was assessed. Using the QOL questionnaire SF-36, the effectiveness of complex standard and osteopathic methods of treating patients with autonomic dysfunction syndrome was revealed.
Voenno-medicinskij žurnal. 2020;341(10):73-75
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Features of spa treatment of patients with osteochondrosis of the cervicothoracic spine, combined with cardiac arrhythmias

Bai S.A., Skorikova A.V., Timkina V.V., Palchevskii D.A., Glushko M.V., Abakumov V.E.


The article is devoted to studying the influence of physiotherapeutic and balneological methods of health resort treatment of patients with osteochondrosis of the cervicothoracic spine on the course of cardiac arrhythmias. The use of complex health resort treatment made it possible to increase the heart’s propulsive work with a more economical consumption of oxygen to normalize the neuroendocrine processes that underlie the formation of arrhythmias. In patients with osteochondrosis of the cervicothoracic spine in the presence of cardiac arrhythmias, this method of treatment does not worsen the course of arrhythmia. Still, it leads to positive dynamics in the gradation of rare ventricular monomorphic extrasystoles, and in 93% of cases - to their complete disappearance.
Voenno-medicinskij žurnal. 2020;341(10):76-78
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The use of acupuncture in the treatment of Guillain-Barre syndrome

Bobyleva E.S., Zakusilova I.P.


The clinical characteristics of acute peripheral paralysis, or Guillain-Barre polyradiculoneuropathy, are given. An example of the use of acupuncture in the treatment of this disease in severe form is provided. The high efficiency of applying various acupuncture techniques as part of the complex therapy of polyneuropathy has been shown. Their use is recommended for military medical organizations with an acupuncture room as part of the physiotherapy department.
Voenno-medicinskij žurnal. 2020;341(10):78-80
pages 78-80 views

1465th Naval Hospital celebrates the 70th anniversary

Murynin V.A., Sokolov A.P., Ivanchikhin N.I., Khomitskii A.A., Zhabin A.V.


August 2020 marks the 70th anniversary of the creation of the 1465th Naval Hospital - now branch No. 3 of the 1472nd Naval Clinical Hospital of the Russian Ministry of Defense. Nowadays, the naval hospital is a multidisciplinary institution that employs highly qualified doctors and nurses. All specialists of the branch have extensive experience in treating patients with surgical, therapeutic, infectious diseases. The specialists successfully solve the problems of medical support in conditions of an increase in the number of troops in the area of responsibility, carry out therapeutic and preventive, educational, methodological, scientific and practical, information and analytical work, improve the organization of the branch’s work based on the principles of the territorial system of medical support.
Voenno-medicinskij žurnal. 2020;341(10):81-85
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Medical support of military operations during the Civil War in Russia (on the example of the Northern Front)

Troshina T.I.


The conduct of a civil war differs from other wars not only in tactics and strategy but in the particular importance of organizing medical affairs, in the forms of the evacuation of the wounded from the battlefield, since in conditions of civil confrontation, the attitude towards the wounded becomes a weapon of ideological struggle. The civil war in Russia took place on different fronts and often in various forms. The intensity of the clashes, the relationship between the army and the local population was due to the natural and climatic conditions. Primary care for the wounded in a civil conflict often took the form of improvisation. The article attempts to reconstruct military doctors’ daily activities in the specific conditions of the Northern Front, specifically its Arkhangelsk region. Due to the limited source base, the author used a set of sources of different nature, applying the procedure of their cross - checking.
Voenno-medicinskij žurnal. 2020;341(10):85-92
pages 85-92 views


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Voenno-medicinskij žurnal. 2020;341(10):93
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Voenno-medicinskij žurnal. 2020;341(10):94-96
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