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Vol 341, No 12 (2020)


Unified military medical information system of the medical service of the armed forces: opportunities for creation and development strategy

Kuandykov M.G., Krainyukov P.E., Stolyar V.P., Lim V.S.


The issues and problems accompanying the development, practical implementation, and development prospects of a unified military - medical information system of the Russian Armed Forces’ medical service are considered. The issues of creating a new (digital) medical service management system and the organization of information and analytical support for officials, medical service management bodies and military medical organizations, data processing centers, schemes of their interaction, as well as the structure of the collected, stored, analyzed and transmitted information are analyzed. The procedure for developing forms and methods of organizing functioning and algorithms for new conditions using modern digital technologies has been determined. The listed factors can be the basis for a tactical and technical assignment to develop a unified military - medical information system, methodological materials, and a new control system as a whole.
Voenno-medicinskij žurnal. 2020;341(12):4-19
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Regulatory status of clinical guidelines for medical rehabilitation

Terganov K.A., Kirsanova A.A., Kovlen D.V., Matytsin N.O., Kondrina E.F., Ishchuk V.N., Adkhamov B.M.


The importance of clinical guidelines in the standardization and legal regulation of medical activity in Russia is shown. Trends, prospects and problematic issues of implementing clinical guidelines in practical health care are considered, taking into account the reorientation of legal regulation of medical activity from the standards of medical care to clinical guidelines. Rehabilitation with the formation of treatment and rehabilitation programs based on clinical recommendations for physical and rehabilitation medicine at the sanatorium - resort stage can significantly (by an average of 25%) increase the effectiveness of such programs, including up to 89% in patients with ischemic disease hearts, up to 93% - with hypertension, up to 91% - with osteoarthritis and up to 88% - in patients with dorsopathies. Simultaneously, the proportion of people who have achieved the criteria for high treatment efficiency increases by 18%.
Voenno-medicinskij žurnal. 2020;341(12):20-25
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Voenno-medicinskij žurnal. 2020;341(12):25
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Pathogenetic rationale and the first experience of using direct high - volume endolymphatic therapy in the treatment of patients with COVID-19 and bilateral polysegmental interstitial pneumonia

Esipov A.V., Kharitonov V.V., Kislenko A.M.


The use of natural high - volume endolymphatic therapy in treating severe forms of lung damage in patients with COVID-19 with the addition of a secondary infection is pathogenetically substantiated. The results of its implementation in 10 seriously ill patients with this pathology were analyzed. On days 1-2, after the start of endolymphatic therapy, the patients improved gas exchange, decreased respiratory failure symptoms, and oxygen saturation in the blood increased to 95-97%. The need for artificial lung ventilation disappeared, and on the 7-10th day, the patients switched to spontaneous breathing. Body temperature, heart rate, and blood pressure returned to normal already on the 2-3rd day. On the 3-4th day, appetite improved, and the sense of smell was restored. There were no lethal outcomes.
Voenno-medicinskij žurnal. 2020;341(12):26-34
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Clinical and pathomorphological characteristics of a meningococcal infection with a fatal outcome in young people

Zhdanov K.V., Kovalenko A.N., Chirskii V.S., Zakharenko S.M., Nalivkina N.A., Sharabkhanov V.V., Ivanov K.S., Shishkin M.K., Yaremenko M.V., Khairutdinova R.A.


To increase the efficiency of medical care for patients with a generalized form of meningococcal infection, clinical manifestations, and pathomorphological changes in young people with a fatal outcome of the disease have been studied. The main clinical form was meningococcemia with fulminant development. The disease was characterized by a sudden onset, rapid progression of typical symptoms: chills, febrile fever, headache, and myalgia. Signs of the development of septic shock were severe hypotension, often vomiting and loose stools. Hemorrhagic exanthema was always detected on the first day of meningococcemia, in some patients - 4-6 hours after the early symptoms. The leading complications and critical conditions in almost all patients with meningococcemia were a septic shock, disseminated intravascular coagulation, and acute adrenal insufficiency. The immediate cause of death was a septic shock (97.1%), in one case, necrotic meningoencephalitis. The timeliness of identifying the first manifestations of a generalized form of meningococcal infection, the provision of emergency care at the prehospital stage, and the speedy hospitalization contribute to maintaining life and health in this category of patients.
Voenno-medicinskij žurnal. 2020;341(12):35-40
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Features of the development of antibacterial immune response and chemokines

Moskalev A.V., Gumilevskii B.Y., Andreev V.A.


The article discusses the main features of the development of an antibacterial immune response with chemokines’ participation. The evolutionary changes in the mutual influence of cells carrying out bacterial phagocytosis are reflected. It has been established that one of the critical links of phagocytosis is the interaction of cells of the monocytic - phagocytic system (neutrophils, monocytes, macrophages) with endothelial cells, which is carried out through the production of cytokines - chemokines and ensures the development of the phase of strong adhesion of neutrophils and overcoming the transendothelial barrier. Many bacteria prevent the development of phagocytosis by disrupting the chemokine system’s work due to the production of proteases. Bacterial proteases also act on intracellular signaling pathways, which inactivates the activity of cells of the monocytic - phagocytic system. The listed intimate mechanisms ultimately contribute to the development of incomplete phagocytosis and the accelerated apoptotic death of phagocytes.
Voenno-medicinskij žurnal. 2020;341(12):40-46
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Voenno-medicinskij žurnal. 2020;341(12):46
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Experience of using computer posturography for pre - flight and post - flight control of the functional state of the body of pilots

Zhiltsova I.I., Alzhev N.V.


The informational significance of computer posturography was determined for assessing the functional capabilities of flight personnel during pre - flight and post - flight medical examinations. Based on changes in the integral indicator of the balance function’s quality, two groups of pilots were singled out: group 1 - with worsening postural function, group 2 - with its improvement. In the 1st group, after the flight load, an increase in adaptation mechanisms’ functional tension was recorded (an increase in the total power of the heart rate variability spectrum and a deterioration in postural stability). Deterioration of postural function was accompanied by an increase in the amplitudes of oscillations of the spectrum of the posturographic signal frequencies. In the 2nd group, after the flight load, a decrease in psychoemotional stress was noted, accompanied by a decrease in the power of the shallow frequency zone of the heart rate variability spectrum and an improvement in postural stability. With the improvement of postural function, the amplitude of oscillations of the spectrum of the posturographic signal decreases. The high information content of the statokinesiogram and the stabilogram spectrum was revealed when assessing the functional state of the pilot’s body.
Voenno-medicinskij žurnal. 2020;341(12):47-54
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Voenno-medicinskij žurnal. 2020;341(12):54
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Efficiency of ultrasound diagnostics of adrenal glands incident during a screening examination

Demyanenko A.V., Rybchinskii S.S., Bakasova A.V.


To assess the possibility of sonography during a screening study as part of an in - depth medical examination during the clinical examination, a comparative analysis of the data obtained with the results of computed tomography was carried out, through which 55 cases of adrenal gland formations with dimensions of 13.4±7 mm were diagnosed in 32 men (age - 72.5±11.42 years) and 18 women (67.2±18.1 years). Using echography, right - sided adrenal incidentalomas were detected in 65% of cases with a focal pathology size of 25.1±6.5 mm, and left - sided ones - in 17% of cases with 24±5.8 mm. The obtained data cannot be interpreted as acceptable and useful for screening examination.
Voenno-medicinskij žurnal. 2020;341(12):55-57
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Options for coronary steal syndrome during atherosclerotic occlusion of the left subclavian artery in the remote period after mammary coronary artery bypass grafting

Zalesov V.E., Gaidukov A.V., Zamskii K.S., Shatokhina A.D.


The article presents a clinical description of two cases of coronary steal syndrome in the distant period after mammary coronary artery bypass grafting affected by insufficiency of functioning mammary coronary shunts due to atherosclerotic occlusion of the subclavian arteries. In one of the observations, latent potential reserves of systemic coronary circulation in atherosclerosis were found.
Voenno-medicinskij žurnal. 2020;341(12):57-59
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On memorable meetings with Lieutenant-General of the Medical Service E.I.Smirnov

Ibadulin R.R.


The article is devoted to the description of official contacts of the author, head of the Military Medical Faculty at the Central Institute for Advanced Medical Studies, with the outstanding figure in Russian medicine E.I.Smirnov, lieutenant - general of the medical service, academician of the Academy of Medical Sciences of the USSR, Hero of Socialist Labor. Over the years, he headed the Main Military Sanitary Administration of the Workers’ and Peasants’ Red Army, the Ministry of Health of the USSR, and the Military Medical Academy named after S.M.Kirov, one of the offices of the General Staff of the Ministry of Defense of the USSR.
Voenno-medicinskij žurnal. 2020;341(12):59-61
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The military health - resort «Marfinsky» celebrates the 90-th anniversary

Dolgikh S.V., Kirsanova A.A., Sobolev A.V., Gulevatyi G.V.


The history of the creation and development of the military health - resort «Marfinsky» is presented. Particular attention in the article is paid to the organization and content of the treatment, diagnostic work of the sanatorium, its rehabilitation directions, and modern methods of treatment in the sanatorium conditions.
Voenno-medicinskij žurnal. 2020;341(12):62-65
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On the history of the Military Medical Academy: musical pages

Petrov R.E.


The article is devoted to the musical culture within the Imperial Military Medical (Medico - Surgical) Academy walls at the turn of the 19th - 20th centuries. The emergence of such a culture was a continuation of amateur home music - making in tsarist Russia. Among the teachers and graduates of the Academy, in whose lives music played an important role, it is necessary to name not only such bright and famous names as chemist A.P.Borodin, therapist S.P.Botkin, surgeon V.A.Oppel, parasitologist E.N.Pavlovsky, but also less famous, for example, the military doctor V.V.Okunev - a representative of the undeservedly forgotten St. Petersburg dynasty of doctors Okunev.
Voenno-medicinskij žurnal. 2020;341(12):66-72
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Pamyatnye daty istorii voennoy meditsiny v 2021 godu

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Voenno-medicinskij žurnal. 2020;341(12):72-74
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Voenno-medicinskij žurnal. 2020;341(12):74
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Miloserdie Pobedy

Poddubnyy M.V.
Voenno-medicinskij žurnal. 2020;341(12):75-76
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Novaya kniga po gigiene aviatsionnogo truda

Vorona A.A.
Voenno-medicinskij žurnal. 2020;341(12):77
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Voenno-medicinskij žurnal. 2020;341(12):78-80
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Association of veterans of the military medical service celebrates the 20th anniversary

Kalachev O.V., Kornyushko I.G., Medvedev V.R., Pozdnyakov A.V., Popov O.A., Sobolenko A.K.


The article summarizes the work of the Interregional Public Organization «Association of Veterans of the Military Medical Service» for 20 years. The organization’s main task was to resolve issues of the medical, social, and legal protection of veterans of the military medical service. Activities were carried out in such areas as social protection of veterans, perpetuating the memory of prominent organizers of the military medical service, assistance to military medical specialists in mastering the profession, mentoring, military - patriotic education of youth, etc. Soon, it is planned to complete work on the creation of 9 more new regional veteran organizations in the Central and Western military districts.
Voenno-medicinskij žurnal. 2020;341(12):81-85
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Perechen' statey, napechatannykh v 2020 g. v «Voenno - meditsinskom zhurnale»

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Voenno-medicinskij žurnal. 2020;341(12):86-96
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