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Vol 342, No 1 (2021)


Medical support of the Armed Forces of the Russian Federation in the context of a pandemic of a new coronavirus infection: results of activities and tasks for 2021

Trishkin D.V.


An analysis of the activities of the medical service of the Armed Forces in the context of a pandemic of new coronavirus infection in 2020, the dynamics of the incidence of military personnel and the load of the bed fund of military medical organizations of the Ministry of Defense allocated for patients with COVID-19 is presented. Indicators of work on re - profiling the bed fund, conducting sanitary and anti - epidemic (preventive) measures in the troops, providing assistance to foreign states and civil health care, including using mobile multidisciplinary hospitals, a temporary infectious disease center based on the Military - Patriotic Park of Culture and Rest The Armed Forces of the Russian Federation «Patriot», newly built infectious disease centers based on military hospitals, as well as separate medical and nursing teams. Regime restrictive measures in sanatorium - resort organizations, medical rehabilitation measures for patients who have undergone COVID-19 in severe and moderately severe forms have been analyzed. The indicators of uninterrupted provision of necessary medical equipment, additional professional training (retraining) of medical personnel are disclosed. The features of medical support for mass events in an unstable sanitary and epidemiological situation for a new coronavirus infection have been determined. The results of the research work and the introduction of innovative achievements into military medicine were evaluated. In the planned activities of military medicine, the achieved decrease in primary morbidity was noted, the need for further development of the air sanitary evacuation system, the system of remote telemedicine consultations, the implementation of programs to improve oncological care and the fight against cardiovascular diseases, work on the formation of a regulatory legal framework, and improvement of the material - technical base. The main tasks for 2021 have been formulated, considering the emerging sanitary and epidemiological situation.
Voenno-medicinskij žurnal. 2021;342(1):4-19
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A hybrid approach to the surgical treatment of acute pulmonary embolism with a high risk of early death

Koltunov A.N., Lishchuk A.N., Esipov A.V., Esion G.A., Brovko L.E., Karpenko I.G., Baksheev V.I.


The paper presents surgical treatment experience using hybrid technologies in 65 patients with acute pulmonary embolism with a high risk of early death and the presence of a floating thrombus in the inferior vena cava system. Thromboembolectomy with simultaneous implantation of a cava filter in the presence of a floating thrombus within the «golden» hour reduces the risk of death and repeated pulmonary embolism in the early postoperative period. A modern approach with the participation of a multidisciplinary team, the presence of a hybrid operating room, which combines high - tech equipment, a highly qualified medical and nursing team, allows one stage to provide a full scope of surgical treatment for patients with pulmonary embolism and save the lives of more than 90% of patients.
Voenno-medicinskij žurnal. 2021;342(1):20-27
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Epileptic seizures after a concussion are an urgent and complex issue in military medical expertise

Litvinenko I.V., Bazilevich S.N., Odinak M.M., Emelin A.Y., Naumov K.M., Datsko A.V., Petrova O.N., Koryakin S.V.


Carrying out a military medical examination of service members with the consequences of a traumatic brain injury requires a comprehensive analysis of all pathogenesis factors and the establishment of a causal relationship when making an expert opinion based on a detailed study of the available medical documentation. The article provides a modern understanding of concussion and post - traumatic epileptic seizures. The possibility of the occurrence of post - traumatic epilepsy after a trauma of the brain is considered in detail, the factors that make it possible to correctly determine the cause - and - effect relationship between seizures and traumatic brain injury are specified.
Voenno-medicinskij žurnal. 2021;342(1):27-37
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Intracellular causative agents of community - acquired pneumonia in young people: etiological significance, clinical and laboratory features, optimization of empirical antibiotic therapy

Krylov V.A., Starikov V.N., Poddubnyi R.V., Etlis M.S., Bobovich O.S.


The study aimed to assess the etiological role of intracellular (atypical) pathogens (Mycoplasma pneumoniae, Chlamydophila pneumoniae) in developing community - acquired pneumonia in young people. It is shown that these pathogens for the period 2015-2019 were the cause of community - acquired pneumonia in 21.7% of cases, mainly in young recruits and military personnel with a service life of fewer than six months. Clinically, community - acquired pneumonia was characterized by moderate fever (body temperature £38 °С) on admission, unproductive cough, and poor auscultatory picture in the lungs. According to the laboratory examination results in favor of community - acquired pneumonia, with a high probability of caused by intracellular pathogens, the unexpressed components of the systemic inflammatory response syndrome (leukocytosis, the level of C-reactive protein) testify. Radiographically, unilateral infiltration of lung tissue, mainly of a small (up to 3 segments) volume, is more characteristic.
Voenno-medicinskij žurnal. 2021;342(1):38-42
pages 38-42 views

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Voenno-medicinskij žurnal. 2021;342(1):42
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Antimicrobial action of the peptide pentadefenine

Gumilevskii B.Y., Andreev V.A., Kolobov A.A., Shamova O.V., Kolobov A.A., Ivanov F.V.


The article discusses the problems associated with the acquired resistance of microorganisms that cause purulent - septic complications in patients treated in hospitals. The spectrum of causative agents of hospital infections in the clinics of the Military Medical Academy is shown. The advantages and directions of the application of antiseptics created based on nanotechnology are presented. The study of the antimicrobial activity of pentadefenine, a synthetic analog of the natural peptide indolicidine, against the most significant causative agents of pyoinflammatory infections was carried out. The determination was carried out by the method of serial dilution in a nutrient medium containing microorganisms. We used a standard technique with minor modifications developed, considering the specifics of the study of antimicrobial peptides. The drug’s property has been established to actively suppress multidrug - resistant hospital strains of microorganisms, which makes it promising for topical use in surgery.
Voenno-medicinskij žurnal. 2021;342(1):43-48
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Voenno-medicinskij žurnal. 2021;342(1):48
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Physiological and psychological assessment of female military personnel in preparation for the Tank Biathlon competition

Ganapolskii V.P., Rzhepetskaya M.K., Grinchuk S.S., Luchnikova O.V., Marchenko L.O.


The article presents the analysis of the physiological and psychological state of female military personnel who, for the first time, took part in preparation for the «Tank Biathlon» competition. In most cases, the physiological, psychophysiological, and psychological indicators of female military personnel during the competition corresponded to the normative values. Changes in the indicators of heart rate variability, blood pressure during exercise tests in some participants, decreased concentration of attention, the ability to distribute and switch, the presence of «reduced» operator performance testified to the tension of the physiological systems of the body and the development of the process of fatigue during training. Further exposure to intense psychoemotional and physical exertion can lead to a breakdown in professional military activity, especially in persons with an imbalance of nervous processes. One of the factors determining the success of the professional training of crews is physical fitness. It is necessary to provide for the possibility of medical and psychological support for their professional military activities to optimize the state of the organism, the level of physical and operational performance of female military personnel.
Voenno-medicinskij žurnal. 2021;342(1):49-53
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Methodological approaches to assessing the nutritional status of military personnel in the Armed Forces of the Russian Federation and the US Army

Smirnova G.A., Ishchuk Y.V., Konovalova I.A., Kravchenko E.V., Andriyanov A.I.


The study aimed to develop proposals for improving the methodology for assessing servicemen’s nutritional status based on an analysis of existing approaches in the Russian Armed Forces and the US Army. In the regulatory documents of the Russian Ministry of Defense, there is no uniform, typical for the entire system of rationing indicators of nutritional status. Therefore, in connection with which it is necessary to establish them both in military medical examination and annual medical examination of military personnel. The need to increase the number of age groups of military personnel and develop standards for determining their nutritional status, including female military personnel, whose number in the Armed Forces is continually increasing, is shown. An indicator of body fat percentage should be used, considering age and sex, to assess nutritional status and body mass index.
Voenno-medicinskij žurnal. 2021;342(1):53-59
pages 53-59 views

Experience in medical support for autonomous diving descents in open and closed equipment using artificial breathing gas mixtures

Zverev D.P., Khaustov A.B., Ryzhilov D.V., Fokin S.G., Myasnikov A.A., Andrusenko A.N., Tomshinskii M.Y., Myasnikov A.A.


Studying the experience of medical support for autonomous diving descents in open and closed equipment with a changeable supply of breathing gas mixtures with different values of the partial pressures of oxygen and indifferent gases are presented. Sixteen participants of the expedition, divided into two groups (divers immersed in equipment with a closed breathing circuit; divers immersed in equipment with an open breathing circuit), were examined, in which the initial functional state of the body was determined, and in the process of 18 autonomous diving descents to depths of 60 up to 120 m studied the dynamics of indicators of the cardiovascular, respiratory, central nervous systems, psychophysiological states, cognitive mental functions before and after diving. After each descent underwater, the level of decompression gas formation was determined by the divers. No pronounced negative changes in the functional state of the divers’ organism were revealed.
Voenno-medicinskij žurnal. 2021;342(1):60-67
pages 60-67 views

On the rationing of medicines for patients undergoing medical rehabilitation in sanatorium - resort organizations of the Ministry of Defense of the Russian Federation

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


The results of research work on improving the standardization of medical property for sanatorium - resort organizations of the Ministry of Defense of the Russian Federation. for the first time, the range of drugs necessary for medical rehabilitation in a military sanatorium was determined. The results obtained are of great importance for the Armed Forces’ medical service since they are the normative and legal basis for determining the need, reclaiming, and purchasing drugs in military health resorts.
Voenno-medicinskij žurnal. 2021;342(1):68-75
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A case of long - term extracorporeal membrane oxygenation in the treatment of acute respiratory distress syndrome in a patient with COVID-19

Kryukov E.V., Chernetsov V.A., Shestopalov A.E., Stets V.V., Zhuravlev A.G., Morgachev V.V., Meshcheryakov D.S.


The most common clinical manifestation of COVID-19 is a bilateral lung disease, with acute respiratory distress syndrome (ARDS) developing in 3-4% of cases. The experience of using extracorporeal membrane oxygenation with the ineffectiveness of mechanical ventilation in the treatment of ARDS in patients with coronavirus infection is insignificant. The article demonstrates a case of long - term (30 days) use of extracorporeal membrane oxygenation in a patient with viral total lung disease, CT-4, severe acute respiratory distress syndrome. The possibility and efficiency of the long - term application of the method are presented. Anticoagulant therapy using low molecular weight heparin (enoxaparin) is adequate, reduces the risk of bleeding, determines the duration and effectiveness of using a membrane oxygenator, and reduces the likelihood of thrombosis of the extracorporeal circuit, and preserves its oxygenating function.
Voenno-medicinskij žurnal. 2021;342(1):76-79
pages 76-79 views

Early diagnosis of Parkinson’s disease at the outpatient stage

Kravchenko T.A., Popov A.P.


The rapid increase in the number of neurodegenerative diseases is due to an increase in life expectancy, increased environmental pollution, chronic stress, and primarily social. Twenty - two patients with Parkinsonism manifestations were examined to assess the effectiveness of early diagnosis of Parkinson’s disease in the premotor period. Differential diagnosis of the disease was carried out, treatment was prescribed. It is shown that the use of methods for early diagnosis of Parkinson’s disease allows timely diagnosis and prescribing of appropriate therapy that improves the patient’s quality of life.
Voenno-medicinskij žurnal. 2021;342(1):79-80
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70th anniversary of the direction of biomedical research at the 12th Central Scientific Research Institute of the Ministry of Defense of the Russian Federation

Erofeev G.G., Chebanov S.Y., Pankratov V.V.


The data summarized over 70 years of biomedical research in the 12th Central Research Institute of the Ministry of Defense of the Russian Federation and their scientific and practical results. Reflected is the personal and collective contribution of the staff of the Institute’s medical and biological subdivisions to the solution of scientific and military - applied problems of assessing the damaging effect of nuclear explosion factors and non - traditional weapons on the personnel of the troops and the population, protecting personnel from the impact of the adverse aspects of a nuclear explosion, ensuring radiation - hygienic and electromagnetic safety of personnel during the operation of weapons and military equipment, medical and psychological support for the professional activities of military specialists. The current state and development prospects of the direction of biomedical research of the Institute have been determined.
Voenno-medicinskij žurnal. 2021;342(1):81-87
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Voennyy vrach, patriot, vernyy drug: pamyati Sergeya Viktorovicha Afon'kina

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Voenno-medicinskij žurnal. 2021;342(1):88-92
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Voenno-medicinskij žurnal. 2021;342(1):93
pages 93 views

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Voenno-medicinskij žurnal. 2021;342(1):94-96
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