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Vol 342, No 8 (2021)


Legal aspects of providing the high - tech medical care to military personnel

Khubulava G.G., Turchenyuk S.N., Lyubimov A.I., Volkov A.M., Lyubimova E.M., Fisun A.Y.


An analysis of the modern regulatory framework governing the provision of the high - tech assistance to military personnel outside military medical organizations is carried out. Incomplete compliance of bylaws with the current federal legislation was revealed, which in a number of cases may limit the right of military personnel to free medical care, enshrined in the Constitution of the Russian Federation and the Federal Law «On the Status of Military personnel». The ways of bringing the legislation in line with the actual state of the country’s modern health care are proposed: approval of new Rules for reimbursing medical organizations for the costs of providing medical care to military personnel, amendments to the Federal Law of 27.05.1998, No. 76-FZ «On the status of military personnel», which will allow military personnel to in exceptional cases, seek emergency assistance in the organization of a private health care system.
Voenno-medicinskij žurnal. 2021;342(8):4-7
pages 4-7 views

Correlation relationships between the volume of the prostate gland and the age groups of military personnel

Krainyukov P.E., Rybchinskii S.S., Kotkovets N.A.


To assess the correlation of the volume of the prostate gland with age, its ultrasound examination was carried out in 140 military personnel in 5 age groups: 1st - 40-44 years (42.5±1.33), 2nd - 45-49 (47.2±1.36), 3rd - 50-54 (52.1±1.37), 4th - 55-59 (56.9±1.37) and 5th - 60 years and older (61, 9±1.92 years). The following volumetric parameters of the prostate gland were obtained: for the 1st group - 22.5±4.78 cm3, the 2nd - 23.7±5.18, the 3rd - 26.9±6.32, the 4th - 31.0±10.53 and 5th - 43.9±15.89 cm3. There is no intragroup correlation between the age of military personnel and the volume of the gland (rЈ|0.3|). There was a statistical significance of differences (pЈ0.05) between the 3-5th groups and its absence between the 1st and the 2nd. Thus, a significant increase in the volume of the prostate gland, which is the basis of organ hyperplasia, begins at the age of 50, which is 5-10 years later than the average in the population.
Voenno-medicinskij žurnal. 2021;342(8):8-12
pages 8-12 views

Digital solutions in the choice of surgical tactics in victims with severe trauma (injury)

Kasimov R.R., Zavrazhnov A.A., Makhnovskii A.I., Samokhvalov I.M., Popenov O.V., Digurov Z.V.


Optimal conditions and the best results of treatment of victims (including military personnel) with polytrauma are achieved in level I trauma centers. The key factor in the success of treatment is the possibility of prompt medical evacuation of victims, even in an extremely serious condition, from trauma centers of levels III-II to central and district clinical hospitals, which are analogs of level I trauma centers. The area of medical responsibility of the chief medical specialists of the Western Military District includes 26 constituent entities of the Russian Federation, and the victims are primarily delivered to the medical organizations of the Ministry of Health. In this regard, the process of making managerial decisions to determine surgical tactics and carry out a medical evacuation of victims to trauma centers of military medical organizations of a higher level is complicated and time - consuming. The analysis of treatment and medical evacuation of 258 victims with severe trauma accompanied by shock and (or) coma in the Western Military District in 2015-2020, including 131 (89.9%) - with polytrauma (ISSі18). Medical evacuation was carried out in 232 cases (89.9%). Digital software solutions have been developed to optimize, accelerate the collection and transmission of objective information about the severity of the injury and the transportability of victims.
Voenno-medicinskij žurnal. 2021;342(8):12-19
pages 12-19 views

Optimization of surgical treatment of the pilonidal cyst in a military base hospital

Larionov Y.V., Sekachev A.A., Kozlov A.N.


The study aimed to develop, evaluate the effectiveness and introduce into surgical practice an improved technique for applying U-shaped sutures with free - lying threads when closing a wound defect after radical excision of the pilonidal cyst. The technique provides an optimal and comfortable treatment process, significantly shortens the length of hospital stay, avoids the need for drainage in the early postoperative period, minimizes the risk of disease recurrence, and achieves aesthetic results. There were no complications in the postoperative period. The duration of the postoperative period was 6-7 days, the sutures were removed on the 8-9th day, on the 10th day the patients were discharged under the supervision of the unit doctor. All wounds healed by primary intention. There were 2 distant relapses (4.2%), which were associated not with the technique, but with the individual characteristics of the architectonics of the tissues of the sacrococcygeal region.
Voenno-medicinskij žurnal. 2021;342(8):20-24
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The case of dissection of a coronary artery clinically simulated as the chronic pericardial effusion

Tsygvintsev A.A., Lishchuk A.N., Shakhnovich P.G.


In the program for combating cardiovascular diseases in the Armed Forces of the Russian Federation, an important place is given to the prevention of sudden cardiac death. At the same time, the group of maximum risk includes military personnel with combined coronary and non - coronary pathology, in which there are objective difficulties in diagnosis, conservative treatment, and the provision of high - tech medical care. A clinical case of subtotal atherosclerotic heart disease with dissection of the coronary artery proceeding under the mask of chronic exudative pericarditis against the background of acquired heart disease is presented. The tactics of managing such patients are analyzed from the standpoint of evidence - based medicine.
Voenno-medicinskij žurnal. 2021;342(8):24-27
pages 24-27 views

Histological and immunohistochemical changes in the skin of the face, developing as a result of the effects of combined laser radiation

Shanina N.A., Yakovenko A.I., Patrushev A.V., Samtsov A.V., Plakhov V.N.


In order to assess pathological changes in the skin after exposure to the combined Er:YAG and Nd:YAG laser, 15 patients (3 men and 12 women) aged 38 to 66 years were examined with signs of aging of the skin of the face and neck (Fitzpatrick phototype I-III). Two procedures of combined (erbium and neodymium) laser irradiation were carried out on the Fotona SP Dynamis apparatus according to the Fotona 4D technique with an interval of 1 month. Skin biopsy was performed on all patients at the screening and 2 months after the start of the study. Histological examination after laser exposure showed an increase in the thickness of the epidermis, an increase in the number of capillaries in the dermis. Immunohistochemical methods revealed increased expression of the CD34 antigen in the zones of newly formed vessels, as well as an increase in the number and density of collagen fibers. Combined laser radiation showed a high efficiency of remodeling of the skin of the face and neck.
Voenno-medicinskij žurnal. 2021;342(8):28-32
pages 28-32 views

Remodeling of the left ventricular myocardium in military personnel with arterial hypertension

Solodyannikova Y.M., Solovyanovich E.V., Trushcheleva T.P., Dudkina G.P.


In a unselected single - point indiscriminate study, the features of remodeling of the left ventricular myocardium in hypertension in military personnel with increased body weight were studied. The study involved 82 patients. It was found that with arterial hypertension combined with increased body weight, as well as with arterial hypertension without increased body weight, hypertrophy of the left ventricle of the heart develops, leading to myocardial remodeling. Moreover, the higher the body mass index, the longer the duration of the disease.
Voenno-medicinskij žurnal. 2021;342(8):33-37
pages 33-37 views

The use of the functional diagnostic tests for the additional assessment of the risk of cardiovascular diseases during an in - depth medical examination of military personnel

Popov A.P., Leksina N.Y., Kudinova S.P., Petrov S.V., Samodeenko O.A., Bekker A.K., Levina A.E., Dolgova E.V., Batueva N.B., Abramova M.V.


The article presents the results of a prospective study carried out to assess the additional results obtained by the methods of functional and ultrasound diagnostics for the effective identification of cardiovascular risk factors in male military personnel during an in - depth medical examination. The application of the examination criteria established by the temporary instruction on the organization of medical examination, preventive and medical and health - improving measures, and dispensary observation of military personnel of the Armed Forces (2019) has increased the effectiveness of the primary detection during an in - depth medical examination of military personnel with risk factors for cardiovascular and atherosclerotic diseases. Suggestions for completing the diagnostic algorithm are given.
Voenno-medicinskij žurnal. 2021;342(8):37-46
pages 37-46 views

Features of the etiological structure of acute respiratory infections in military teams deployed in different territories in the epidemic season 2019-2020

Alimov A.V., Kalmykov A.A., Aminev R.M., Mukhachev I.S., Artebyakin S.V., Mamontov O.I., Slobodenyuk A.V., Vyalykh I.V., Markaryan A.Y., Chalapa V.I., Malchikov I.A.


The study aims to determine the features of the etiological structure of acute respiratory infections in military groups. The contribution of various pathogens of respiratory infections of a viral and bacterial nature to the structure of infectious pathology of the respiratory tract of personnel of 8 military teams in the territory of the Ural, Volga, and Siberian federal districts during the epidemic season 2019-2020 is shown. The causative agents of respiratory diseases were determined by the polymerase chain reaction method. The leading role in the epidemic process was played by viruses of non - influenza etiology (pathogens of parainfluenza, adenovirus, respiratory syncytial infection), causing mono - and mixed infection of military personnel. The share of causative agents of influenza was 3-20.8%, causative agents of acute respiratory viral infections of non - influenza etiology - up to 62.5%, Chlamydia pneumoniae - up to 29.1%.
Voenno-medicinskij žurnal. 2021;342(8):47-51
pages 47-51 views

Assessment of neurophysiological indicators of medical and psychological rehabilitation of military personnel

Ivanov I.V., Kaverina E.A., Zheltyi O.P.


The study covered 67 male contract military personnel aged 25-40 who underwent 10-day medical and psychological rehabilitation in a military sanatorium in Central Russia in the summer. The dynamics of neurophysiological indicators testifies to the normalization of the electromyogram and alpha - rhythm of the encephalogram after the application of complex treatment and methods of psychological correction. Control of neurophysiological parameters is an important criterion for the restoration of the functional state of military personnel during the rehabilitation period.
Voenno-medicinskij žurnal. 2021;342(8):52-58
pages 52-58 views

Strategies of professional behavior in a situation of uncertainty and risk in the activities of the pilots of the Aerospace Forces

Aldasheva A.A., Lim V.S., Lekalov A.A., Runets O.V.


Individual and personal characteristics of pilots are considered, linking the uncertainty of the professional situation, firstly, with information; secondly, with knowledge, abilities, skills, experience; thirdly, with a negative emotional state. It is discussed within the framework of the developed concept of «professional - role» trust of a specialist, his idea of actions in a situation of uncertainty and risk. The results of the study showed that pilots who associate uncertainty with the quality of the information received trust not only themselves but are also focused on joint activities and interaction with their colleagues, demonstrate three types of professional strategy - for themselves, for others, and the situation. Pilots who define uncertainty as a lack of knowledge, skills, and abilities, emphasize the importance of knowing the algorithms of activity, assessing the social situation and themselves in it, they are characterized by confident behavior, orientation towards interaction. The leading strategies in professional activity are focusing on oneself and one’s knowledge, on another. For pilots who describe uncertainty as an emotionally significant situation, the leading strategy is to focus on themselves, to assess their ability to cope with the situation.
Voenno-medicinskij žurnal. 2021;342(8):59-65
pages 59-65 views

Experience in performing combined operations in patients with rectocele and hemorrhoids

Davidyan N.Z., Bondaruk M.A.


The results of treatment of two patients with lower proctoptosis of the 2nd degree in combination with chronic combined hemorrhoids of the 2nd stage were evaluated. The first was the lower levatoroplasty by the transvaginal approach in combination with closed hemorrhoidectomy, the second - the lower levatoroplasty by the transvaginal approach in combination with the instrumental circular resection of the mucous - submucosal layer of the rectum (Longo’s operation). Longo’s operation in combination with levatoroplasty can significantly reduce the severity of pain in the early postoperative period and shorten the rehabilitation time. After 10 months, long - term results were regarded as «good» (no complaints, clinical and functional symptoms of rectocele and chronic hemorrhoids) in both patients.
Voenno-medicinskij žurnal. 2021;342(8):66-67
pages 66-67 views

Self - regulation and co - regulation as a form of partnership in the health sector

Sushilnikov I.S.


Institutions of self - regulation and co - regulation in the field of health protection as a form of partnership between the state and business are analyzed. Studied the constitutional and legal problems of self - regulation and co - regulation in health care. Self - regulation as a form of partnership between business and government has drawbacks due to insufficient protection of citizens’ rights. The institute of co - regulation, which is applied in Russia in the medical field, can become a substitute for the institute of self - regulation.
Voenno-medicinskij žurnal. 2021;342(8):68-70
pages 68-70 views

Using the deep oscillation physiotherapeutic system in the spa treatment of patients with obstructive pulmonary diseases

Sedenkova E.A., Lukin Y.P., Chebotareva L.A., Leonchuk T.Y.


The analysis of the results of the sanatorium - resort treatment of patients with obstructive pulmonary diseases combined with the physiotherapy method of deep oscillation was carried out. To assess the effectiveness, we used functional and clinical examination data before and after the spa treatment at the Kislovodsk resort in the primary and control groups. The best clinical results in treating patients with this pathology are achieved with the combined use of the deep oscillation method.
Voenno-medicinskij žurnal. 2021;342(8):70-72
pages 70-72 views

A case of alcoholic myocardial injury with infarction - like symptoms

Solodyannikova Y.M., Solovyanovich E.V., Trushcheleva T.P.


A clinical case description provides an analysis of a complicated and rarely found in medical practice diagnostic situation - the development of heart attack - like changes on the electrocardiogram in a young patient after drinking alcohol without signs of chronic alcohol abuse. With suspicion of myocardial infarction, the patient was sent for examination to a hospital. After additional examination, including coronary angiography, the diagnosis of myocardial infarction was excluded.
Voenno-medicinskij žurnal. 2021;342(8):72-74
pages 72-74 views

Branch No. 5 of the N.N.Burdenko Main Military Clinical Hospital celebrates the 70th anniversary

Davydov D.V., Goryachev I.A.


Full services of the entire spectrum of medical care is provided at branch No. 5 of the N.N.Burdenko Main Military Clinical Hospital. The main activity of the branch (hospital) is aimed at further improving medical care for military personnel and other decreed contingent by introducing innovative methods of diagnosis and treatment.
Voenno-medicinskij žurnal. 2021;342(8):75-79
pages 75-79 views

Pharmaceutical training for the Russian army and navy: history and current state

Miroshnichenko Y.V., Bunin S.A., Kononov V.N., Perfilev A.B.


The experience of the medical supply of troops (forces) shows that the effectiveness of the functioning of this important component in the structure of military health care largely depends on the level of training of the pharmaceutical personnel. The article describes the historical evolution of the training of pharmaceutical personnel for the army and navy of Russia from the era of Peter I to the present. The contribution of the Military Medical (Medico - Surgical) Academy to the formation and development of domestic pharmaceutical education, education, and training of pharmaceutical specialists was highly appreciated. The article describes the modern multi - level system of training pharmaceutical personnel for the army and navy of Russia, which implements the educational «trajectory» - specialty, residency, magistracy, and postgraduate studies. The prospects for the development and improvement of this system in the interests of preserving and strengthening the health of military personnel are shown.
Voenno-medicinskij žurnal. 2021;342(8):79-87
pages 79-87 views

Ofitsial'nyy otdel

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Voenno-medicinskij žurnal. 2021;342(8):88-90
pages 88-90 views

Lenta novostey

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Voenno-medicinskij žurnal. 2021;342(8):91-96
pages 91-96 views

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