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Vol 342, No 3 (2021)


Military medical expertise in the Armed Forces of the Russian Federation: traditions and modernity

Kuandykov M.G., Datsko A.V., Kamenskov N.N., Kabalin A.P., Koryakin S.V.


The article reflects the main stages of the formation of domestic military medical expertise, as well as issues of improving the structure of bodies and institutions of military medical knowledge from their creation in 1921 to the modern period in the history of the Main Center for Military Medical Expertise of the Ministry of Defense of the Russian Federation. Currently, the military medical expertise has acquired the status of a state institution, whose activities are aimed at ensuring the recruitment of the Armed Forces with citizens who meet the requirements for their state of health, for the implementation of social benefits and guarantees established for servicemen (former military personnel).
Voenno-medicinskij žurnal. 2021;342(3):4-11
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Ways to improve military medical expertise of the citizens subject to conscription

Datsko A.V., Cherkashin V.S., Tokarev V.D., Kabalin A.P., Sergoventsev A.A., Pastukhov A.G.


Analyzed the results of medical examination of citizens subject to military service and medical examination at the assembly points of constituent entities of Russia of citizens called up for military service. Medical workers take the measures to ensure the quality of manning of the Armed Forces, and control over the validity of conclusions about the category of fitness for military service are outlined. When conscripting for military service has sufficient reliability to ensure the recruitment of citizens who meet the requirements for their state of health, the current army medical expertise system has adequate reliability. The proposed legislative and organizational changes to the medical support system for the conscription of citizens for military service will allow the future to maintain a high quality of man.
Voenno-medicinskij žurnal. 2021;342(3):12-19
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Military medical examination for urolithiasis in the Armed Forces (analysis of work published in 2015-2019)

Kryukov E.V., Protoshchak V.V., Paronnikov M.V., Karpushchenko E.G., Datsko A.V., Petrova O.N., Nikolaev O.V., Borisov A.G.


A statistical analysis of the results of a medical examination of service members on conscription and contract with a urolithiasis diagnosis in 2015-2019 is presented. The study includes expert opinions that, following the Russian legislation, could be the basis for early dismissal of service members for health reasons due to limited suitability and inadequacy for military service. The dynamics of medical expert outcomes was investigated by analyzing time series and calculating the second - order polynomial trend. When determining the degree of renal dysfunction in relation to Article 72 of the Schedule of Diseases to estimate the glomerular filtration rate, instead of the Cockcroft - Gault formula, it was proposed to use the CKD-EPI formula (Chronic Kidney Disease Epidemiology Collaboration, 2011), as well as to amend the wording of the explanations to Article 72 Schedules of diseases. The question of using the sup nosological concept of chronic kidney disease in the assessment of renal dysfunction during military medical examination is discussed. The development of modern technologies for diagnosing and treating patients with urolithiasis dictates the need for the earliest clarification of the criteria for assessing renal function during the military medical examination.
Voenno-medicinskij žurnal. 2021;342(3):19-25
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Voenno-medicinskij žurnal. 2021;342(3):25
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Temporary endovascular prosthetics of the inferior vena cava in case of damage to its subhepatic segment is an innovative approach to the treatment of severe liver injuries

Reva V.A., Samokhvalov I.M., Golovko K.P., Nosov A.M., Demchenko K.N., Petrov A.N., Voronin S.E., Mikulich A.A., Zheleznyak I.S., Denisov A.V.


Severe liver injuries with ruptures of the inferior vena cava constitute one of the unresolved problems of damage surgery. Mortality with such an injury reaches 80% or more. The authors proposed a method of hybrid intervention, which consists of complete vascular isolation of the liver by performing Pringle and temporary arthroplasty of the inferior vena cava with a removable stent - graft installed through access to the femoral vein. In an experiment on two large pigs, liver damage of the V degree was simulated, and a removable stent graft was implanted. When angiography received a picture of the vascular isolation of the liver, and clinically achieved a complete stop of bleeding, allowing the operation to be performed on a «dry» liver. Unlike balloon occlusion of the damaged segment of the inferior vena cava, a stent - graft will enable you to save blood flow to the heart and avoid circulatory arrest. There were no fatal outcomes during the operation. Thus, the method of temporary arthroplasty of the inferior vena cava can be considered as an alternative way to stop bleeding with severe liver injuries, accompanied by blood loss from the hepatic veins or the posthepatic department of the inferior vena cava.
Voenno-medicinskij žurnal. 2021;342(3):26-31
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Chronic kidney disease affecting the determination of the category of fitness for military service

Kryukov E.V., Datsko A.V., Potekhin N.P., Sarkisov K.A., Borisov A.G., Petrova O.N., Koryakin S.V.


Based on a retrospective analysis of 535 approved certificates of illness for military personnel, it was examined by military medical commissions of the central military medical organizations of the Russian Ministry of Defense within one year, data on the prevalence of chronic kidney disease in them, its role in the formation of an expert diagnosis and the impact on the conclusion on the determination categories of fitness for military service. There were 154 (average age 20.6 years) and 381 (39.4 years) under contract among the surveyed conscripts. Criteria for chronic kidney disease were identified in 123 (23%) military personnel, which is significantly higher than the proportion of renal pathology (6.9%) reflected in the clinical diagnosis. For the formation of a register of patients with chronic kidney disease in the Armed Forces, analysis of the causes (etiology) of its development, prevalence among military personnel, and the impact on their dismissal rate, it is advisable to reflect in the structure of the expert diagnosis, if any, the markers of this pathology, its stratification by glomerular filtration rate and level albuminuria/proteinuria, regardless of its influence on the conclusion on the category of fitness for military service according to the primary diagnosis.
Voenno-medicinskij žurnal. 2021;342(3):31-37
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Immediate results of extended and combined operations in patients with locally advanced pelvic cancer

Solovev I.A., Surov D.A., Vasilchenko M.V., Kostyuk I.P., Galaka A.A., Balyura O.V.


The study aimed to evaluate the immediate results of multi - visceral resections of the pelvic organs in 319 patients with locally advanced pelvic cancer. The average age is 67.2±9.8 years (41-89 years), women - 172 (53.9%), men - 147 (46.1%). From 2009 to 2020, all patients underwent combined (n=141) and extended (n=178) surgical interventions of various volume, 89 patients underwent evisceration of the pelvic organs. Postoperative complications were observed in 136 patients (42.6%). Postoperative mortality - 4.4%. The incidence of complications after surgery in patients with a complicated tumor course (104 cases, 63.8%) was significantly higher than in uncomplicated ones (59, 36.2%). Complications developed significantly more often after combined (78 cases, 57.3%) operations than after extended ones (58, 42.7%). Purulent - septic complications were more common (33.7% in the structure). Despite the traumatic nature of extended and combined operations, the immediate results can be regarded as satisfactory with adequate provision of the perioperative period.
Voenno-medicinskij žurnal. 2021;342(3):37-45
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Dental morbidity of military personnel in the military garrison of the Republic of South Ossetia - State of Alania

Pavlovets S.A., Grebnev G.A., Kul’nev S.V., Ivanov V.V., Zubov N.N.


The purpose of the study was to assess the dental health of conscripts and contract service members in a military garrison on the territory of the Republic of South Ossetia - State of Alania. The authors studied the state of organs and tissues of the oral cavity in 1017 service members aged 18-59. Non - carious lesions of the teeth were found in 66.6% of persons, caries - in 100%. The need for dental treatment is 93.9%. Carious and filled teeth dominated the structure of the KPUz index. Simultaneously, a large proportion of service members with extracted teeth, including those with unsubstituted orthopedic constructions of dentition defects (26.2%), determines a high need for orthopedic care. Only 25.4% of those examined had healthy periodontal tissues. Inadequate and unsatisfactory levels of cavity hygiene were found in 30.1% of cases. The survey results show the high need for service members in all types of dental care, which confirms the existence of a problem in the medical provision and the need to search for ways to improve it in the armed forces of the republic.
Voenno-medicinskij žurnal. 2021;342(3):46-49
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The role of lipid - cholesterol metabolism disorders in the development of arterial hypertension in young and middle - aged

Gordienko A.V., Dydyshko V.T., Yakovlev V.V., Serdyukov D.Y., Barsukov A.V., Kabisova V.I.


An in - depth examination of 436 military men of young and middle age was carried out. Based on the Framingham Total Cardiovascular Risk Scale, the subjects were divided into low - risk groups without arterial hypertension, low risk with arterial hypertension, medium risk without arterial hypertension, and medium risk with arterial hypertension. It was found that in men with prehypertension and grade I arterial hypertension, regardless of the category of cardiovascular risk, there was a significant positive relationship between the intensity of smoking and the level of blood pressure and the content of atherogenic lipids and lipoproteins in the blood; degree of obesity with heart rate, blood pressure level and Apo B/Apo A1 ratio. The transformation of prehypertension into arterial hypertension in men with low and medium cardiovascular risk is combined with increased serum total cholesterol, low - density lipoprotein cholesterol, triglycerides, and atherogenic coefficient, lowering high - density lipoprotein cholesterol.
Voenno-medicinskij žurnal. 2021;342(3):50-56
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Labial herpes in dental practice

Grishin O.V., Shishelova A.Y.


The article describes the etiology, stages, and manifestations of labial herpes. The data on the vital activity of the herpes simplex virus type 1, its interaction with the carrier’s organism, and manifestations in the oral cavity both during primary infection and recurrent infection are presented. Risk factors for a doctor and a patient of herpetic orolabial disease during dental treatment and general risk factors for herpes simplex virus type 1 reactivation from a latent state are presented. The modern methods of diagnostics and therapy of labial herpes are indicated. The data presented demonstrate the high potential for the spread of the virus in the body, the successful fight against which is determined mainly by the level of immune defense - both the local barrier, the area of the virus invasion zones, and systemic lymphocytic immunity. Modern methods of therapy contribute to a faster recovery with labial herpes, but at the moment, there are no effective specific means of preventing its recurrence.
Voenno-medicinskij žurnal. 2021;342(3):57-65
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Development of the system of medical examination of aviation personnel of the state aviation of the Russian Federation

Sergoventsev A.A., Pastukhov A.G., Zemlyakov S.V., Datsko A.V., Churilov Y.K., Vovkodav V.S., Petrova O.N., Richei I.I.


Medical certification of aviation personnel of state aviation is an essential element of selecting citizens for flight work, flight management, parachute jumping, and flight training. The existing organization of their medical examination for a long time has not undergone significant changes. The current stage of development of aviation and military medicine requires an increase in the quality indicators of the work of medical - flight commissions for medical examination of aviation personnel specialists in outpatient and inpatient conditions, bringing their activities in line with the changed regulatory legal acts of Russia, the development and implementation of new approaches to the formation of requirements for the state health of aviation personnel in various types and types of aviation. This article is devoted to the organization’s analysis and the main directions of the development of the system of medical examination of aviation personnel of the state aviation of Russia.
Voenno-medicinskij žurnal. 2021;342(3):66-73
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Voenno-medicinskij žurnal. 2021;342(3):73
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Military medical examination of anorexia nervosa (clinical case)

Datsko A.V., Cherkashin V.S., Pashkovskii R.D., Novik M.V.


A clinical case of diagnosis and military medical examination of anorexia nervosa in a 23 - year - old man is presented, diagnosed with anorexia nervosa on the background of schizoid personality disorder, lingering neurotic disorder. To exclude anorexia nervosa at an early (initial) stage in citizens subject to conscription for military service, specialist doctors (therapist, neurologist, psychiatrist) need to carefully collect anamnesis on the dynamics of body weight, if there is a desire to lose weight, analyze its causes, organize an experimental psychological examination.
Voenno-medicinskij žurnal. 2021;342(3):74-76
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A clinical case of pulmonary embolism occurring as a community - acquired pneumonia in a conscript soldier

Bekmurzov S.M., Makarevich A.M., Morozov M.A., Khabibrakhman E.P., Isakov D.V., Davidovich I.M.


The article presents a clinical case of pulmonary embolism in a conscripted 23 - year - old soldier with a congenital anomaly of the hemostasis system due to polymorphism of the folate cycle genes PAI-1 (4G/4G homozygote), ITGA2 (T/T homozygote), which has not been initially diagnosed during the outbreak of community - acquired pneumonia. Gram - negative infection occurred, with the development of septicopyemia, multiple organ failure, and, despite intensive care, a lethal outcome occurred.
Voenno-medicinskij žurnal. 2021;342(3):77-79
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The use of total extraperitoneal hernioplasty for inguinal hernias in a garrison hospital

Lomakin D.N., Redkozubov A.A., Margaryan A.S., Ushakov M.V.


The experience of using extraperitoneal hernioplasty in a garrison hospital is presented. It has been shown that the use of this technique, in comparison with the open access according to Liechtenstein, significantly improves the quality of life of patients in the early and late postoperative periods reduces the average bed - day, promotes the rapid return of service members to serve, and also significantly reduces the likelihood of recurrent inguinal hernias.
Voenno-medicinskij žurnal. 2021;342(3):80-81
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The experience of organizing the treatment of acute pancreatitis in the hospital of a military clinical hospital

Panov V.V., Kim I.Y.


The modern approaches to the diagnostic and treatment process in patients with acute pancreatitis in a military clinical hospital are described. The characteristics of methods for diagnosing acute pancreatitis, determining its severity are presented. The latter is a criterion for referring a patient to the appropriate functional unit of a military hospital.
Voenno-medicinskij žurnal. 2021;342(3):81-82
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The effectiveness of normoxic and hyperbaric oxygenation in the complex spa treatment of patients with diabetes mellitus

Antonov P.F., Vikulin S.A., Pavlova I.V., Lisinskaya O.N., Vasileva S.B., Novozhilova M.V.


The efficacy of hyperbaric (32 people) and normoxic (35 people) oxygenation in the complex spa treatment of 77 patients with diabetes mellitus were studied. All patients achieved improved controlled performance. When determining the effectiveness of the treatment using methods of objectifying the quality of life and the dynamics of the blood glucose level, there are no statistically significant differences. Given the lower cost of a session of normal oxygenation, it is advisable to use this treatment method.
Voenno-medicinskij žurnal. 2021;342(3):82-85
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Voenno-medicinskij žurnal. 2021;342(3):85
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The contribution of domestic scientists to the development of approaches to the evacuation of the wounded by air transport in the 1930s

Sokolov V.A., Tsvetkov D.S.


An analysis of the sources of the 1920s-1930s devoted to the study of indications and contraindications for the evacuation of the wounded and sick by air to medical institutions are presented. The importance of troops’ experience of medical and evacuation support in local armed conflicts of the 1920s-1930s is noted. And the results of experimental studies study a wide range of theoretical issues related to aircraft use in solving the problem under consideration. The original tables - diagrams of indications and contraindications for aviation evacuation, developed by domestic scientists, are presented. Their work was based on an analysis of the experience of practical flights of medical aviation in various countries and regions of the USSR, observations of the wounded during flights, and the results of experiments with animals. An active exchange of specialists’ opinions and their publications in the press made it possible to clarify many theoretical positions and formulate new approaches to aviation’s most reasonable areas for medical and sanitary purposes.
Voenno-medicinskij žurnal. 2021;342(3):86-91
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Voenno-medicinskij žurnal. 2021;342(3):92-93
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Voenno-medicinskij žurnal. 2021;342(3):94-96
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