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Vol 343, No 6 (2022)

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Organization of medical support for the military establishment

Evaluation of the success of the fight against a new coronavirus infection (COVID-19) in military units

Korshever N.G., Vasilyeva М.А., Dorfman Y.R., Zhuravlev V.К., Royuk V.V.

Abstract

The purpose of the study is to assess the success of the fight against a new coronavirus infection in military units, including in the dynamics of the pandemic. Specialists of the Center for State Sanitary and Epidemiological Surveillance of the Southern Military District, based on the characteristics of three levels (high, medium, low) of the gradation of 38 informative criteria substantiated in the study, twice assessed the success of the fight against COVID-19 in 80 military units. The data obtained during the primary (within the first wave of the pandemic) and dynamic (second wave) assessments were analyzed. Data from the initial assessment of informative indicators of the fight against COVID-19 showed that the state of its success is insufficient. Based on the materials of the re-evaluation, a statistically significant positive dynamics of this process was established. By all indicators, the state of combating NCI has improved statistically significantly. In the vast majority of military units, their high level is set: in 93.8–100% of military units, this level is noted for 34 out of 38 indicators, and in 85% for the other 4. In other cases, an average level was determined. The low level was not recorded.

Voenno-medicinskij žurnal. 2022;343(6):4-10
pages 4-10 views

Emergency medicine

Reconstruction of criminal events by finite element analysis based on a video recording of surgical intervention

Pinchuk P.V., Leonov S.V., Levandrovskaya I.А.

Abstract

Currently, abdominal surgeons successfully perform organ-preserving operations for blunt trauma to the spleen. The video recording of the operation is the primary carrier of information about the morphology and localization of organ damage, since such information is often poorly and ambiguously reflected in the patient’s medical documents. The article presents data on the modeling of splenic injury by finite element analysis based on a video recording of surgical intervention, through which, with the study of the patient’s medical documentation and video recording of the course of surgical intervention, morphological features, localization of organ damage are established as accurately as possible and the mechanism of their formation is substantiated.

Voenno-medicinskij žurnal. 2022;343(6):11-14
pages 11-14 views

Using psychotherapy with hyperventilation load in the medical and social rehabilitation of combatants and airmen

Ivanov I.V., Milanin А.А., Zheltyi О.P., Stas Y.V.

Abstract

The results of psychotherapy with hyperventilation load in the process of complex treatment of 517 male patients aged 22–52 years, of which 306 were combat veterans and 211 were airmen, were analyzed. The frequency of psychotherapeutic effects and individual clinical reactions during the technique was assessed. Indications and contraindications for its implementation for persons undergoing medical and psychological rehabilitation in sanatoriums, hospitals and specialized rehabilitation centers have been developed. When evaluating the indications for the use of the technique, care must be taken, since some individuals may have manifestations of increased convulsive activity of the brain, as well as the effects of temporary personality disorientation. A clinical approach to determining indications and contraindications for the use of psychocorrection in combination with hyperventilation load allows avoiding potential complications and minimizing the risk of their occurrence for patients with post-traumatic stress disorders.

Voenno-medicinskij žurnal. 2022;343(6):15-21
pages 15-21 views

Treatment and prophylactic issues

Clinical experience of prescribing regdanvimab to inpatients with a new coronavirus infection COVID-19 and a high risk of its unfavorable course

Sergoventsev А.А., Patsenko М.B., Demyanenko А.V., Afonaskov О.V., Zelenov М.V., Pomogaibo B.V.

Abstract

The aim of the study is to establish the relationship between the prescription of regdanvimab in a group of patients with a new coronavirus infection COVID-19 older than 50 years and risk factors with the development of a severe course of the disease, the duration of inpatient treatment, and adverse events. The new antiviral drug regdanvimab is a monoclonal antibody directed against the receptor-binding domain of the spike protein of the SARS-Cov-2 virus. The retrospective study included data from 40 patients over 50 years of age hospitalized with mild COVID-19 and at high risk of severe disease. Early additional administration of regdanvimab to the main treatment prevents the progression of the disease, significantly (by 5.9 days) reduces the duration of inpatient treatment in the group of patients older than 50 years with risk factors for an unfavorable course of the disease, and is not accompanied by adverse reactions to the administration of the drug.

Voenno-medicinskij žurnal. 2022;343(6):22-26
pages 22-26 views

Features of the diagnosis of local chemical burns of the gastric mucosa in military conscripts

Byzov N.V., Butin Е.V., Plekhanov V.N.

Abstract

To improve the quality of diagnosis of local chemical burns of the gastric mucosa, the results of primary esophagogastroduodenoscopy and histological examination of its biopsy specimens were studied in 22 conscripts (main group) who used dry aggressive chemicals to simulate diseases of the upper digestive tract in the period from 2006 to 2017. The control group included conscripts (n=20) with acute deep erosion and acute gastric ulcer. Established endoscopic (the presence of a large defect in the mucous membrane of the «loop» of less deep damage, spreading toward fluid movement in the stomach; a decrease in the depth of the burn ulcer or erosion from the center to the edges; localization of a local chemical burn of the gastric mucosa on the greater curvature of the distal third of the body or antrum of the stomach) and histological (the presence of a scab on the surface of the defect; mild inflammatory infiltration of the mucous membrane with pronounced necrotic and necrobiotic changes in the integumentary-pit and glandular epithelium) differential diagnostic signs of a local chemical burn of the gastric mucosa.

Voenno-medicinskij žurnal. 2022;343(6):27-33
pages 27-33 views

Experience in medical rehabilitation of patients who have undergone COVID-19 in the health resorts of the North Caucasian health resort complex of the Russian Ministry of Defense

Antonov P.F., Sitnikov О.V., Dolgikh S.V., Kirsanova А.А., Kovlen D.V., Abuseva G.R., Adkhamov B.М., Shishkin Y.М.

Abstract

Based on the results of laboratory, functional and psychological examinations, the effectiveness of medical rehabilitation of 84 patients who underwent COVID-19 and entered for rehabilitation at the sanatorium of the North Caucasian health resort complex was assessed. The best results in a sanatorium at the 3rd stage of medical rehabilitation of such patients are achieved in eliminating hypoxia, inflammatory changes, and signs of depression. Also, there was a significant positive dynamics in the recovery of indicators of the function of external respiration, physical performance, subjective assessment of the severity of the condition according to the Borg scale when performing the test with a 6-minute walk, a decrease in the severity of signs of anxiety and depression. For a quarter of patients, after the implementation of the measures of the 3rd stage of medical rehabilitation in the conditions of a sanatorium, it is necessary to continue restorative measures in an outpatient setting or independently, as well as to implement measures for dispensary observation.

Voenno-medicinskij žurnal. 2022;343(6):33-39
pages 33-39 views

The effectiveness of the treatment of abuse headache in an outpatient setting

Meshcheryakova Y.B., Tankova О.I., Guseva G.V.

Abstract

Abusive headache (drug-induced) develops as a result of excessive intake of analgesics, triptans, ergotamine derivatives for the treatment of headache attacks. The most effective methods of treatment are the discontinuation of the «guilty» drugs, as well as the combination of pharmacotherapy with non-pharmacological methods, including behavioral therapy. In the clinic of the 12th consultative and diagnostic center of the Ministry of Defense, 28 patients with drug-induced headaches were treated. Including 12 received detoxification therapy in the conditions of the hospital department of the polyclinic (day hospital). We have established the dependence of the subjective characteristics of sleep on the intensity of the pain syndrome. The advantages of combining detoxification therapy with preventive treatment during the period of withdrawal of the «guilty drug» were revealed.

Voenno-medicinskij žurnal. 2022;343(6):49-55
pages 49-55 views

Medical and psychological rehabilitation of military personnel diagnosed with overwork and obstructive sleep apnea

Demeev Y.А., Skachkov О.А., Bai S.А.

Abstract

An analysis of the screening study of sleep indicators in military personnel undergoing medical and psychological rehabilitation in a sanatorium with a diagnosis of overwork is presented. The effectiveness of CPAP therapy to treat asthenic syndrome with overwork against the background of moderate and severe obstructive sleep apnea has been shown. To diagnose obstructive sleep apnea and vegetative manifestations of overwork, screening diagnostics of night sleep indicators by monitoring computer pulse oximetry, a SAN questionnaire, a subjective scale for assessing asthenia, the «Level of Subjective Control» method, the Beck anxiety scale were used, aim indicators were evaluated before and after treatment. The positive effect of CPAP therapy on improving the quality of recovery of psychosomatic parameters of the body in the presence of obstructive sleep apnea has been proven.

Voenno-medicinskij žurnal. 2022;343(6):55-59
pages 55-59 views

Features diagnostics and military medical examination of non-alcoholic fatty liver disease

Grinevich V.B., Datsko А.V., Kravchuk Y.А., Bakushkin I.А., Arapkhanova М.М., Petrova О.N., Koryakin S.V.

Abstract

Non-alcoholic fatty liver disease is a widespread and steadily progressive pathology throughout the world. The basis of the pathogenesis of this disease is a violation of the structure and function of the intestinal microbiome with a change in the permeability of the intestinal mucosa barrier, the development of intestinal endotoxemia, cytokine aggression, oxidative stress, chronic systemic inflammation of low intensity, insulin resistance and hyperinsulinemia. The clinical picture of the pre-cirrhotic stage of the disease is characterized by a low severity of symptoms. Non-alcoholic fatty liver disease is a diagnosis of exclusion and requires a comprehensive evaluation of the patient. Currently, there is a tendency to an increase in the number of conscripts and overweight military personnel who have this pathology. The formulation of a clinical and expert diagnosis in non-alcoholic fatty liver disease has important features that must be taken into account when conducting a military medical examination.

Voenno-medicinskij žurnal. 2022;343(6):40-48
pages 40-48 views

Air and navy medicine

Psychophysiological and physiological aspects of piloting and maintaining spatial orientation in the mode of super-maneuverability

Chekhovskii L.V., Zhdanko I.М., Vorona А.А.

Abstract

Based on the analysis of literary sources, the authors made an assessment of some psychophysiological and physiological aspects of piloting and maintaining spatial orientation in the super maneuverability mode. They pay particular attention to assessing the impact of multi-vector accelerations and the nature of overloads on the pilot’s body, which should be considered when conducting psychophysiological preparation for flights on modern fighter aircraft. Another - not high-speed, but super-maneuverable (when the “maneuver” mode is turned on to compensate for the drop in the efficiency of aerodynamic rudders at supercritical angles of attack by controlling the engine thrust vector). The authors analyzed the probability of occurrence of spatial disorientation and various kinds of illusions during piloting in the super maneuverability mode.

Voenno-medicinskij žurnal. 2022;343(6):60-67
pages 60-67 views

Военная фармация и медицинская техника

Implementation of modern approaches to the provision of medical oxygen in military healthcare

Miroshnichenko Y.V., Enikeeva R.А., Shchegolev А.V., Vertii B.D.

Abstract

The characteristics of the modern approach to the oxygen supply of the stages of medical evacuation and military hospitals are given. The main tactical and medical-technical characteristics of a mobile unit for receiving, accumulating (storing), delivering, distributing medical gaseous oxygen (MUPC-KBA-93) adopted for the supply of the Armed Forces are presented. The advantages of the method of short-cycle non-heating adsorption for obtaining medical oxygen, implemented in the installation, are shown. The results of studies on the registration of a new drug «Medical Oxygen, 93%» and the development of an advising pharmacopeial article are presented. The authors described the main parameters of the quality of this drug. The prospects for further experimental and clinical studies aimed at clarifying the features of the use of medical oxygen 93% are outlined. They conclude that the MUPK-KBA-93 installation made it possible to create a reliable and autonomous system for providing oxygen to medical stages of medical evacuation and military hospitals in the domestic military healthcare.

Voenno-medicinskij žurnal. 2022;343(6):68-72
pages 68-72 views

Brief articles

Experience in organizing the work of a garrison military hospital during the counterterrorist operation in Dagestan (1999–2001)

Bulavin V.V., Golosov S.Y., Amirov А.М., Nikitin V.F., Vorona А.А., Bulavin V.Е., Storozhenko I.V., Avdeeva Т.S.

Abstract

The results of the analysis of the organization and content of the work of the 71st military hospital (Buynaksk) for the reception, provision of medical care to various categories of the wounded and their evacuation to medical institutions of the 2nd and 3rd echelons during the counter-terrorist operation in the Republic of Dagestan (1999–2001). The features of the deployment of the hospital, the staffing structure before and after the outbreak of hostilities, the characteristics of the wounded and the volume of help provided are shown. The authors made a conclusion about the full compliance of the organization of the work of the hospital with the situation, the nature of the assigned tasks, and the opportunities. Modern conditions, in particular the possibility of aeromedical evacuation from a tactical combat zone, cause further scientific development of the problem.

Voenno-medicinskij žurnal. 2022;343(6):73-75
pages 73-75 views

Из истории военной медицины

Saint Luka – Professor V.F. Voyno-Yasenetsky – the spiritual patron of military doctors of the Armed Forces of the Russian Federation

Trishkin D.V., Kalachev О.V., Plakhov А.N., Krainyukov P.Е., Yakovlev А.Е., Kosachev I.D., Serebryanyi R.S., Gorpinich P.V.

Abstract

The article presents the life path, research and medical activities of a prominent figure in Russian medicine, Valentin Feliksovich Voyno-Yasenetsky (1877–1961), who was also an archbishop of the Russian Orthodox Church. Professor V.F.Voyno-Yasenetsky is an outstanding scientist-surgeon, the successor of the ideas of the great N.I.Pirogov, the founder of purulent surgery and regional anesthesia in our country. He treated the wounded during the Russian-Japanese, World War I and the Great Patriotic War. Since 2021, St. Luka (Voyno-Yasenetsky) has been considered as the saint by the Russian Orthodox Church, and has been considered the spiritual patron of military doctors of the Russian Armed Forces.

Voenno-medicinskij žurnal. 2022;343(6):76-85
pages 76-85 views

Branch No. 6 of the A.A.Vishnevsky 3rd Central Military Clinical Hospital celebrates the 35th anniversary

Zhirun P.М., Korzovatykh V.G.

Abstract

In December 2021, Branch No. 6 of the A.A.Vishnevsky 3rd Central Military Clinical Hospital of the Russian Ministry of Defense celebrated its 35th anniversary. This military medical institution began as a specialized hospital in the Saratov region, and now it is a branch of one of the best central military medical organizations in Russia. For decades, the high professionalism of its employees and the cohesion of the team, the desire for development and loyalty to traditions have distinguished the hospital. The team of authors summed up some results of the institution’s activities and share plans for the near future.

Voenno-medicinskij žurnal. 2022;343(6):85-89
pages 85-89 views

Officer, military doctor, teacher (On the 100th anniversary since the birth of G.Kh. Ripp)

Belyakin S.А., Zhidkov S.А.

Abstract

A brief biography and an overview of the multilateral scientific and practical activities of the prominent scientist, organizer of the medical service, doctor of medical sciences, professor, participant in the Great Patriotic War of 1941–1945, colonel of the medical service Geshel Khononovich Ripp (1922–2003) are presented. For over 15 years, he headed the Department of Organization and Tactics of the Medical Service of the Military Medical Faculty at the Tomsk Medical Institute, was the founder of the Museum of the History of Military Medicine in Siberia, the Military Medical Faculty at the Minsk State Medical Institute.

Voenno-medicinskij žurnal. 2022;343(6):89-92
pages 89-92 views

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