Том 334, № 9 (2013)

Current forms of medical reports cannot be used for clinical and epidemiological and medical and economic researches because they don’t contain information about competitive, associated diseases and its complications. Authors developed the method of clinical and epidemiological monitoring of nosologic structure of patients in military-medical institutions based on personalized record-keeping of patients with additional informational resources for recording of all diagnoses and performed medical service. With the help of the given method were analyzed nosologic structure and treatment results of 548 patients with vehicular trauma from the 442 nd District Military Clinical Hospital. Polytrauma was revealed in 22% of patients, concomitant injury — in 39%, combined injures — in 0,4%. Besides, in 8% of patients were revealed associated chronic diseases that not only confound trauma, but also make difficult to diagnose and assess the severity of trauma.

Increasing number of patients with allergy observed in recent years is accompanied with increasing number of health encounters due to acute allergy. The sudden beginning and unpredictable course characterize acute allergy. These factors can be fatal for patient and must be treated immediately. Allergic rhinitis, allergic conjunctivitis, acute urticaria, angioedema and anaphylaxis refer to diseases based on acute allergy. The most dangerous diseases, characterized by fatal conditions, are generalised urticaria, angioedema and anaphylaxis. Knowledge of first aid principles is the most important factor of effective treatment because quickness of allergy progression requires prompt decisions. Use of the whole complex of modern therapeutic possibilities is the most important and durable. Modern methods of first aid for acute allergy, based on recommendations from foreign and domestic publications, are given in the article.

For the last 5 years in the center of vascular surgery of Vishnevskiy 3rd Central Military Clinical Hospital 218 patients with abdominal aortic aneurism were treated, 96 planned surgical operations for abdominal aortic aneurism (post-operative mortality 3,1%) were performed. 11 patients underwent urgent surgical operation because of rupture of abdominal aortic aneurism. 1 of 11 patients died at the stage of laparotomy, the second patient died after clipping of ruptured aneurysm. In other 9 cases surgical operation was performed successfully. But 2 of 9 patients died in a few hours after surgery. In summary, 4 of 11 patients underwent surgical operation for rupture of abdominal aortic aneurism survived. The postoperative mortality was 63,6%. Authors gave an example of successful treatment of patient with rupture of abdominal aortic aneurism. It was concluded that successful treatment of rupture of abdominal aortic aneurism is possible only in case of well-run integration of different treatment and diagnostic departments. CT angiography is crucial for instrumental diagnostics of rupture of abdominal aortic aneurism. Successful surgical operation is impossible without organized blood supply service, refusion and donor blood. Artificial lung ventilation, extracorporal detoxication and adequate pharmacological supply help to avoid severe complications during the postoperative period, even in patients with associated pathology.

Hypertension (HTN) and noninsulin-dependent diabetes mellitus (NIDDM) are two non-communicable pandemic of the late 20th century and early 21st century. Despite the active prophylaxis measures performed by the State, there is a tendency to increase of HTN in Russia. Incidence rate of hypertension is depending of age and increases in patients of elderly age (80%). According to the International Diabetes Federation, 10% of people in Russia suffer NIDDM of different genesis. The authors covered the topical issues of modern strategies in antihypertensive therapy in patients with NIDDM and HTN according to large randomized trials. The authors analyzed the possibilities of conventional and modern therapies of hypertension, organoprotection, metabolic neutrality and impact on prognosis in patients with NIDDM. It is underlined that the renin-angiotensin-aldosterone system is a part of the cardiovascular continuum and links various risk factors, like end-stage of cardiovascular disease and chronic renal disease. Monitoring of arterial blood pressure is crucial for patients with essential hypertension and NIDDM. Pharmacological blockade of the renin-angiotensin-aldosterone system is the most desirable method of treatment of hypertension and noninsulin-dependent diabetes mellitus. This method reduces the risk of cardiovascular complications.

Authors analyzed the health status and morbidity among female soldiers serving under the contract in the Northern Fleet, age peculiarities, results of medical in-patient examination and expert assessment, put in medical records in accordance with prophylactic medical examination service and medical examination. Annual data about military troops, morbidity and medical examination among female soldiers in the period 2002—2010 (n~14,5 thousand of people) are included into analysis. 502 medical records of female soldiers approved by military physician board were analyzed. Authors presented statistic data about primary diseases and chronic pathology and considered causes of changing of the category of fitness for military service and its gender peculiarities. Authors suggest changing the recruiting concept for female soldiers and the system of medical in-patient examination.

Military-medical examination is a part of medical service of the Armed Forces of the Russian Federation and plays a significant role in recruiting military troops with healthy, physically vigorous soldiers, in saving and improving of health of military personnel, in undertaking prophylaxis and therapeutic measures, in solving social problems of servicemen and their families. Military-medical examination board of Eastern Command plays a significant role in the system of military-medical examination of the Armed Forces of the Russian Federation. The article is devoted to the history of formation and development of military-medical examination in the Far East depending on aims and goals of military-medical service at different stages of military formation. Eastern Command dated back to the Civil War, has changed its organization, boundaries, structure and name many times. According these changes many new military-medical departments, including military-medical examination board, were reorganized, disbanded and created. Various military-medical commissions alternating or working simultaneously at different military units were created in the Far East.