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Vol 38, No 4 (2019)

Articles
LEADING DEPARTMENT OF THE MILITARY MEDICAL ACADEMY
Kulnev S.V., Shelepov A.M., Kliuchnikov P.B., Elizarev S.V.
Abstract
The Department of organization and tactics of the medical service, celebrating its 90th anniversary, is the leading Department of the Academy, as well as the leading educational, methodological and scientific center of the Main military medical Department of the Ministry of defense of the Russian Federation. The article presents a historical overview of the teaching of military medicine in the Academy. The Department develops scientific-practical task of building a medical service and medical support of the Armed Forces of the Russian Federation in peace and war, is preparing guidance documents in their field, analysis of efficiency of medical support of troops (forces) in the daily activities of the medical service in combat. The Department has always taken an active part in the development, preparation and conduct of research command-staff and tactics-special doctrines with the medical service the battle of the Armed Forces of the Russian Federation, as well as in stages of Military medical relay with the medical composition of the military districts (fleets), the types of armed forces and arms of troops, including the international stage. The Department carries out a lot of work on the training of qualified personnel of the leadership of the medical service of the Armed Forces of the Russian Federation, as well as military doctors for the most complex link - military. Of particular relevance and relevance are the knowledge and experience of the department staff in modern conditions of the RF Armed Forces reform.
Russian Military Medical Academy Reports. 2019;38(4):5-12
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AREAS OF IMPROVEMENT PRACTICAL MILITARY-CIVIL INTERACTIONIN RESPONSE TO MAJOR RISKS IN ALGERIA
Savchenko I.F., Troshko I.V., Sevrukov V.V., Achouri S.
Abstract
In the course of the study, information on the interaction of the armed forces of the Algerian People›s Democratic Republic and civilian structures during the response to the floods in the Mzab municipality (2008) was studied, analyzed and generalized. In the course of the research work, the main problematic issues in the planning of medical support for the forces involved in the liquidation of the consequences of the flood and the affected population were revealed, which should be paid special attention to when deciding on the organization of civil-military interaction and preparing the medical service for the mission. To maintain national preparedness and improve operational coordination between the NNA and various civic organizations, training (training) search and rescue operations should be periodically carried out, including training in the provision of primary health care to the population and the use of medical equipment with the participation of various specialists. The exercises must involve the forces and means of the NNA, Civil Defense, the Ministry of the Interior, Health, Transport, etc. Both civilian and military specialists have much to do in order to effectively coordinate joint actions to counter potential danger at any time. and anywhere.
Russian Military Medical Academy Reports. 2019;38(4):13-15
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ACTIVITIES OF THE CHIEF MEDICAL CERVICE ON AVIATION ACCIDENT PREVENTION
Blaginin A.A., Trofimenko S.V., Naturalnikov I.O., Lyashedko S.P.
Abstract
Based on the content analysis of legal and legislative acts, as well as official documents of the Ministry of Defense of the Russian Federation on the prevention of aviation accidents, the activity of the head of the medical service (aviation doctor) on the prevention of aviation accidents has been investigated. It has been established that in medical provision of flight safety, in order to prevent aviation accidents, the number of the most characteristic hazards is multiple of their number in all other types of support. At the same time, the number of main general measures to prevent erroneous, incorrect actions of personnel is also more than in other types of flight safety. The most frequently repeated factors dangerous in the medical support of flights are noted and the main general measures carried out by the personnel of the medical service of aviation units to prevent erroneous (incorrect actions) of the personnel are given. Conclusions were drawn on the low efficiency of concentrating efforts to eliminate flight accidents in certain areas of activity of the Chief of Medical Service of the Aviation Unit and on the expediency of complex impact on the whole set of factors that are elements of flight safety. It is shown that the work of the aviation doctor to prevent aviation accidents has a pronounced preventive direction of actions, in the process of professional activity the chief of the medical service emphasizes not only the state of health, but also the prediction of the functional state and efficiency of the pilot. It has been revealed that the basis for the effective work of the aviation doctor to prevent aviation accidents is the priority of measures aimed at increasing the role of the human factor, so it is advisable to emphasize in the training of the aviation doctor (chief of the medical service of the aviation unit) the formation of high mental stability, psychophysiological and moral-will qualities necessary for official activity.
Russian Military Medical Academy Reports. 2019;38(4):16-20
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OPTIMIZATION OF WORK ORGANIZATION AND STRUCTURE OF MILITARY-MEDICAL ORGANIZATIONS IN THE TERRITORIAL SYSTEM OF MEDICAL SUPPORT OF TROOPSIN THE AREA OF TERRITORIAL RESPONSIBILITY
Boldbaatar B., Kasimov N.Z., Savchenko Y.V., Kryuchkov O.A.
Abstract
Today, medicine is actively implementing reforms aimed at improving the quality of medical care provided, which include not only the introduction of advanced medical technologies and modern drugs, but also the formation of new approaches to the composition of medical organizations. Military medicine has always occupied a special position in the healthcare system, which required a more dynamic and informed approach to the provision of medical care to the assigned contingent. This study is devoted to the scientific substantiation of proposals for optimizing the composition of military medical organizations in the territorial system of medical support for troops in the area of territorial responsibility. The proposed principle of optimizing the organization of work and the structure of military medical organizations of the territorial system of medical support can be applied in practice. The developed approach will allow the formation of hospitals that will reduce the financial burden on the defense budget, improve the quality of care and increase the availability of medical care to all categories of citizens who have the legislative right to medical care in military medical organizations.
Russian Military Medical Academy Reports. 2019;38(4):21-24
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EXPERIENCE OF PRACTICAL MILITARY-CIVIL COOPERATION IN FLOOD RELIEF IN THE MUNICIPALITY OF MZAB (ALGERIA, 2008)
Savchenko I.F., Troshko I.V., Kushnirchuk I.I., Achouri S.
Abstract
This article is devoted to studying the existing experience of practical civil-military cooperation in the aftermath of the flood in the Mzab municipality in 2008. The issues of planning the medical support of forces involved in the elimination of the consequences of disasters and the affected population were studied, data were generalized, and proposals were developed for improving the organization of civil-military interaction in emergency situations. In the course of the study, the information on the interaction of the armed forces of the Algerian People›s Democratic Republic and civilian structures during the liquidation of the consequences of the flood in the Mzab municipality was studied, analyzed and generalized. In addition, the main problematic issues in the planning of medical support for the forces involved in the liquidation of the consequences of the flood and the affected population were revealed, which should be paid special attention to when deciding on the organization of civil-military interaction and preparing the medical service for the mission. As a result of the research work, it can be concluded that the experience of civil- military interaction during the flood in Gardai in 2008 was extremely successful, both in terms of organization and the effectiveness of both sides.
Russian Military Medical Academy Reports. 2019;38(4):25-28
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CHARACTERISTIC OF THE UNITED NATIONS PEACEKEEPING OPERATIONS
Alnazarov I.M., Savchenko I.F., Soldatov E.A., Troshko I.V., Sevruko V.V., Sinkevich A.V.
Abstract
This article is devoted to the study of the organization of medical support for peacekeeping operations under the auspices of the United Nations, the management of this process, as well as the study of its support and control. During the study, questions were studied and the organization of medical support for peacekeeping operations within the UN system was described, it was noted how this process is managed, supported and monitored, improvements are proposed that will allow the UN peacekeeping contingent to fulfill its duty to protect health and peacekeeping security. It is noted that the deployment of UN peacekeeping operations is carried out on the basis of mandates provided by the United Nations Security Council. The tasks set differ in different situations depending on the nature of the conflict and the specifics of specific problems. Thus, the charter of the United Nations is the fundamental document for the activities of all UN bodies. The Charter entrusts the UN Security Council with the primary responsibility for maintaining international peace and security. The study revealed that the purpose of medical support for peacekeeping operations is the timely and effective preservation of the health and well-being of UN staff. In addition, it is noted that peacekeeping has always been highly dynamic and has undergone changes under the influence of new challenges.
Russian Military Medical Academy Reports. 2019;38(4):29-33
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ORGANIZATION OF MEDICAL SERVICE SAFETY OF FLIGHTS IN MODERN CONDITIONS
Blaginin A.A., Trofimenko S.V., Naturalnikov I.O., Annenkov O.A.
Abstract
An analysis of the organization of medical provision of flight safety was carried out. It has been established that the aviation doctor builds his work in a complex system of industrial relations. For the purpose of reliable functioning, it has strict regulations, so in its practical activities, the Chief of the Medical Service of the Aviation Unit must punctually comply with the requirements set out in the guidance documents. There is a detailed characteristic of medical provision of flight safety at all stages of their organization and carrying out. It is noted that the prevention of aviation accidents and incidents related to the violation of the health and performance of persons participating in flights includes a whole range of measures carried out by the medical service. Flight safety is shown to be a systemic concept with a pronounced preventive focus. The main link in solving practical tasks of medical provision of flight safety is the m ilitary aviation doctor (head of the medical service of the aviation unit), so he and his special training are subject to high requirements. The aviation doctor needs to be able to assess not only the state of health of the flight crew, but also its physical preparation, psychological stability, functional condition, reserves and, ultimately, its operability. Only professionally trained personnel can successfully solve the abovementioned set of organizational and medical tasks.
Russian Military Medical Academy Reports. 2019;38(4):34-37
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PRESERVATION OF PROFESSIONAL HEALTH AFTER EXPOSURETO INFECTING ACCIDENTAL FACTORS OF ACCIDENTS AND EMERGENCY SITUATIONS
Gatsura V.Y., Butskov S.S., Sivashenko P.P.
Abstract
When eliminating indoor accidents and emergencies, toxic gases - such as carbon monoxide, carbon dioxide, hydrogen chloride, hydrogen cyanide, aldehydes and acrolein - pose the greatest danger, as well as a concomitant lack of oxygen. Recently, there is growing evidence that in the body of employees who are professionally involved in the elimination of accidents and emergencies, a cumulative accumulation of poisons arises from the effects of combustion products on the body. Carcinogenic substances were discovered in the smoke of fires, inducing the development of malignant tumors in the human body. These include: benz(a)pyrene, vinyl chloride, nitrosamine, formaldehyde, the concentration of which significantly exceeds the permissible norms. One of the most dangerous cumulative poisons are dioxins. These compounds are fundamental factors in the pollution of the biosphere, and fires are one of the important sources of dioxin release into the environment. The reason for the toxicity of dioxins is the ability of these substances to fit exactly into the receptors of living organisms and suppress or alter their vital functions. Dioxins, suppressing the immune system and intensively influencing the processes of cell division and specialization, provoke the development of cancer. Dioxins also invade the complex, smooth functioning of the endocrine glands. Interfere with reproductive function, dramatically slowing puberty and often leading to female and male infertility. To select and justify the most promising ways to manage the professional risk of firefighters, a sanocentric approach to studying the effects of smoke on firefighters seems appropriate. The essence of the approach is that not only the danger of death and accidents due to fire should be taken into account, but also the possible long-term biological effects of acute and chronic effects of smoke on the health of firefighters, which has both medical and social significance.
Russian Military Medical Academy Reports. 2019;38(4):38-42
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FEATURES OF MEDICAL SUPPORT OF THE TROOPS OF THE US ARMED FORCES
Kratts V.A., Soldatov E.A., Redkin E.E.
Abstract
The analysis of the organization of medical support for the troops of the US Armed Forces during wars and local conflicts is carried out. In the course of the work, the activities of the US medical service and the principles of medical and evacuation measures are considered. The article discusses the structure of the US medical service, and the role of the medical units themselves in providing various types of medical care to the wounded and sick at the stages of medical evacuation. The article is of interest as a generalization of the positive experience of the US medical service and identification of ways to improve the medical support of the domestic Armed Forces. In the course of the research work, a number of features of the medical support of the US troops (forces) were highlighted, which include: planning and command and control of the forces and means of the medical service (MS) on the basis of principles such as centralization of management at all levels of the MS; continuity of treatment for the wounded and sick; proximity to the wounded; flexibility of healthcare; mobility; consistency of action. A significant distance from the theater of military hospitals and specialized medical centers located in the continental United States. Of great importance is the veterinary service, which monitors the epizootic situation, organizes the detection, isolation and treatment of sick animals belonging to the Ministry of Defense, ensures quality control of fodder and water, as well as an examination of food, preventive, hygienic and other measures aimed at protecting health troop personnel together with the military medical service. In general, the United States of America (USA) is creating a medical support system that allows them to achieve the possibility of conducting military campaigns of various sizes in any theater of operations.
Russian Military Medical Academy Reports. 2019;38(4):43-49
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DISTINCTIVE FEATURES OF MILITARY CONFLICTS AND THEIR IMPACTON MEDICAL CARE
Ivantsov V.A., Tegza V.Y., Yrazmambetov R.T., Chalykh S.N.
Abstract
This article is devoted to the study of the main distinguishing features of military communications, as well as their impact on medical support. In the course of the research, information on the planning of medical support in the conditions of military conflicts was studied, analyzed and generalized. In the course of the research work, the main problematic issues were identified in the planning of medical support for military conflicts, while special attention should be paid to the work of preparing the medical service for the performance of its intended tasks. It was revealed that during the period of military conflicts personnel problems may arise, as a result of the fact that some medical specialists refuse to travel to the combat zone. In the combat units of medical units and subunits, secondment of medical personnel from inpatient hospitals and units of constant readiness for their staffing is required. In military conflicts, treatment and evacuation measures are organized based on the inpatient treatment base on a territorial basis, and the provision of specialized medical care is organized in several echelons. The absence of full-time guard and defense units in the medical units and units necessitates their deployment near guarded military command posts. The magnitude and structure of sanitary losses can vary significantly. The medical service is a source of replenishment of the losses of troops and, thereby, strengthens its role in times of military conflict.
Russian Military Medical Academy Reports. 2019;38(4):50-52
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MODERN WATER TREATMENT FILTERS FOR INDIVIDUAL USE IN THE FIELD
Bokarev M.A., Lopatin S.A., Kuznetsov S.M.
Abstract
In accordance with the theoretical fundamentals of prevention of diseases of servicemen caused by the water factor, the directions and content of medical control and state sanitary and epidemiological surveillance of water supply at points of permanent deployment of troops are presented. The regulatory and legal base regulating the directions of achieving sanitary and epidemiological well-being by organizing a reliable and safe centralized water supply to the population (troops) is given. Laboratory quality control of drinking water and water sources for microbiological, virological and parasitological indicators is carried out by specialists of sanitary-epidemiological institutions, using the appropriate methodological arsenal. Special attention during sanitary and epidemiological surveillance and medical control is drawn to the organization of sanitary protection zones in accordance with the requirements of SanPiN 2.1.4.1110-02. It is noted that the legal and property relations of legal entities, associated with the protection of water sources, the development, approval and maintenance of sanitary protection zones are complex and need further improvement, including upgrading the status of sanitary protection zones for water sources to the level of specially protected natural territories by adopting a special federal law, or appropriate amendments to water, sanitary and environmental legislation. The main control preventive functions of the medical service of military units and sanitary-epidemiological institutions during the design, construction, acceptance and operation of water supply facilities in military camps are substantiated. It is shown that in the chain “vodokanal-regulatory authorities-consumer” existing in each garrison, an important link is the consumer, who is proposed to be considered, as an important and promising link capable of raising the quality control of drinking water, as a product to the proper level. Attention is focused on the predictive role of hygienic diagnosis of risk factors for the deterioration of the health of consumers of water.
Russian Military Medical Academy Reports. 2019;38(4):53-55
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METHODS OF EYE TRACKING AND PROSPECTS OF USING IT FOR THE TRAINING OF AVIATION MEDICINE SPECIALISTS
Blaginin A.A., Sinelnikov S.N., Naturalnikov I.O., Trofimenko S.V., Tkachenko R.I.
Abstract
With the development of photography and filming, the choice of methods for the study of eye movements was increasingly reduced to video recording and subsequent analysis of video material. Currently videooculography modern and useful technique of eye tracking based on the fixation of the pupil with infrared cameras. With the rapid development of aviation technology and update of human factors in the system “man - flying machine”, training of medical professionals who are trained in methods of assessing the functional reserves of attention, the quality of his distribution and General piloting skills is a bylog increase in the level of safety and videooculography - a successful tool to achieve these goals. The method of mobile binocular eye tracking has promising directions in the ergonomic assessment of the pilot›s workplace, which justifies the location of devices on the dashboard, clarifies the display and alarm systems. Support of the pilot by trained medical specialists, control of his physiological and psychophysiological indicators, will provide the possibility of correction of erroneous actions and will allow to avoid accidents in the event of complex flight situations and illusions of spatial position. Analysis of the quality of attention distribution will provide an opportunity to establish the boundaries of the human factor, which will contribute to the timely identification and solution of emerging ergonomic problems.
Russian Military Medical Academy Reports. 2019;38(4):56-58
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FEATURES OF MEDICAL CONTROL OVER THE STATE OF HEALTH OF PERSONNEL OF AIR DEFENSE UNITS WORKING UNDER THE INFLUENCE OF HARMFUL FACTORS OF MILITARY LABOR
Shatilo Y.V., Bevzyuk L.V., Kanibolotskii M.N.
Abstract
Aitracking technique is promising for its practical use in the training of aviation medicine specialists. The article presents the distinctive features of medical control over the state of health of the personnel of the air defense units, in the performance of which there are harmful factors of military labor. The procedure for organizing and conducting a medical examination of personnel at the stage of admission to combat duty during the period of joining combat duty, as well as the features of conducting an in-depth and control medical examination, conducting a medical examination of military personnel working under conditions of exposure to harmful factors of military labor, is considered. Military personnel who, according to the results of a medical examination revealed deviations in their state of health, are taken under dynamic observation, if any medical contraindications are identified, they will be removed from military duty. If it is necessary to clarify the diagnosis, the military personnel are sent for stationary examination to the military clinical hospitals of the military district and the military medical academy. Also, according to the results of medical control measures, the need for military and civilian personnel in medical and psychological rehabilitation is determined. If there is evidence, the personnel are sent for rehabilitation to the nearest sanatorium-resort organizations of the Ministry of Defense by decision of the military medical commission.
Russian Military Medical Academy Reports. 2019;38(4):59-62
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PROCEDURE FOR IMMUNIZATION AND PREVENTION OF MALARIAAND HIV IN PEACEKEEPING OPERATIONS OF THE UNITED NATIONS
Alnazarov I.M., Savchenko Y.V., Kucheynik V.V., Kuprin S.A., Sinkevich A.V.
Abstract
The article studies the issues of determining the order of immunization and prevention of malaria and HIV in peacekeeping operations of the United Nations. In the course of the study, information was most fully studied on the organization of immunization and prevention of malaria and HIV in the peacekeeping contingent. The areas of responsibility of the parties in matters of reimbursement of actual costs during immunoprophylaxis were studied. In addressing the objectives of the study, the main attention was paid to the UN legal framework, the procedure for immunization and prevention of malaria and HIV, the areas of responsibility of the parties in organizing vaccination and reimbursement of actual costs during its implementation were studied. Countries are responsible for vaccinations recommended by the UN. The UN provides the necessary information on the types of vaccinations and preventive measures that all United Nations staff or military contingents should be subjected to before being sent to the area of the peacekeeping operation. If any UN staff or military contingent arrives in the mission area without proper vaccination and prophylaxis, the UN provides them with booster doses and appropriate preventative measures.
Russian Military Medical Academy Reports. 2019;38(4):63-67
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MODERN METHODS FOR ASSESSING THE VALUE OF DAILY ENERGY CONSUMPTION OF SERVICEMEN. THE IMPORTANCE OF ASSESSING THE PHYSICAL ACTIVITY OF SERVICEMEN IN THE ARMY OF THE RUSSIAN FEDERATION
Kuznetsov S.M., Novoselov S.A., Lopatin S.A.
Abstract
One of the achievements of technological progress in the twenty-first century can certainly be considered a reduction for a person (especially for residents of large cities) the need to engage in heavy physical labor daily. To further improve the system of organization of food supply of the armed forces of the Russian Federation it is necessary to have objective information about the actual nutrition and the level of motor activity of the personnel of the armed forces (population of the Russian Federation). The paper describes modern methods for assessing the value of daily energy consumption of a person, as well as determining the type of predisposition to motor activity, based on the analysis of the genome, promising ways to determine the energy consumption of soldiers. In assessing the physical fitness of personnel, three main factors are taken into account. Firstly, this is the total amount of physical activity. Its intensity has an upper limit, individual for each person. Above it, physical performance first ceases to increase, and then decreases. Secondly, this is the presence of a wide range of reactions to the same level of physical activity, which can be manifested by the occurrence of injuries and the failure of a significant part of the trained contingent. Thirdly, this is the adaptation of the musculoskeletal system to severe physical exertion, which usually occurs in two stages, which must be taken into account to prevent excessive physical exertion.
Russian Military Medical Academy Reports. 2019;38(4):68-72
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LEGAL FRAMEWORK FOR MEDICAL MONITORING OF WATER SUPPLY POPULATION (TROOPS)
Bokarev M.A., Lopatin S.A., Kuznetsov S.M.
Abstract
In accordance with the theoretical fundamentals of prevention of diseases of servicemen caused by the water factor, the directions and content of medical control and state sanitary and epidemiological surveillance of water supply at points of permanent deployment of troops are presented. The regulatory and legal base regulating the directions of achieving sanitary and epidemiological well-being by organizing a reliable and safe centralized water supply to the population (troops) is given. Laboratory quality control of drinking water and water sources for microbiological, virological and parasitological indicators is carried out by specialists of sanitary-epidemiological institutions, using the appropriate methodological arsenal. Special attention during sanitary and epidemiological surveillance and medical control is drawn to the organization of sanitary protection zones in accordance with the requirements of SanPiN 2.1.4.1110-02. It is noted that the legal and property relations of legal entities, associated with the protection of water sources, the development, approval and maintenance of sanitary protection zones are complex and need further improvement, including upgrading the status of sanitary protection zones for water sources to the level of specially protected natural territories by adopting a special federal law, or appropriate amendments to water, sanitary and environmental legislation. The main control preventive functions of the medical service of military units and sanitary-epidemiological institutions during the design, construction, acceptance and operation of water supply facilities in military camps are substantiated. It is shown that in the chain “vodokanal-regulatory authorities-consumer” existing in each garrison, an important link is the consumer, who is proposed to be considered, as an important and promising link capable of raising the quality control of drinking water, as a product to the proper level. Attention is focused on the predictive role of hygienic diagnosis of risk factors for the deterioration of the health of consumers of water.
Russian Military Medical Academy Reports. 2019;38(4):73-80
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THE MAIN ISSUES OF MILITARY - MEDICAL TRAINING AND HYGIENIC EDUCATION OF MILITARY PERSONNEL
Bordykov V.A., Luchikov E.A., Bondarev V.N., Devlikamov R.R.
Abstract
This article is devoted to the consideration of the fundamentals of medical training, hygienic education of military personnel and some problematic medical issues in the Armed Forces of Russia. The objectives of the activities of the medical service for hygienic training and education of military personnel, promotion of a healthy lifestyle are: promotion of health legislation; hygienic training and education of military personnel; promotion of a healthy lifestyle, motivation of military personnel to consciously fulfill the requirements of charters, orders, guidelines aimed at maintaining and strengthening their health and physical development; improving knowledge and reinforcing practical skills in providing selfhelp and mutual assistance in injuries and diseases. The problematic issue is the insufficient number of objects of the educational material and technical base for the practical development of questions by military personnel - medical training specialists. Therefore, the heads of the medical service of the command of the branches of the Armed Forces, directorates of operational (operational-tactical) commands, formations, military units need to systematically study the state of this work and provide assistance in the creation of a training and material base. The problematic issue is the insufficient number of objects of the educational material and technical base for the practical development of issues by military personnel - medical training specialists. Therefore, the heads of the medical service of the command of the branches of the Armed Forces, the directorates of the operational (operational-tactical) commands, formations, and military units need to systematically study the state of this work and provide assistance in creating a training and material base.
Russian Military Medical Academy Reports. 2019;38(4):81-84
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THE VARIOUS ACTIVITY FIELDS SPECIALISTS-OPERATORS PSYCHOPHYSIOLOGICAL STATUS CHANGES IN CONDITIONS OF LONG SEALING
Bobrov Y.M., Popov A.N., Irzhevskiy A.I.
Abstract
The article presents the research results of psycho-physiological state specialists, operators logical, sensory and sensory-motor profile, as well as medical monitoring of microcli-mate parameters (temperature, humidity), gas environment (oxygen, carbon dioxide), in conditions of a long way out to sea. Under supervision were 20 people. The survey was carried out in three stages (at the beginning, in the middle and at the end of a long trip to the sea) on a set of techniques-SAN, psychophysiological and clinical-physiological techniques, functional tests. The results obtained at each stage of the survey were carefully analyzed, compared with each other, and the dynamics of changes in the indicators of functional status for the entire period of professional activity was revealed. Despite the rather comfortable living conditions (habitability parameters did not exceed the permissible indicators) for all specialists, for the entire time of going to sea, the subjects underwent multidirectional changes in the indicators of the physiological state, however, pronounced changes that could lead to poor performance were not detected. Secondly, the various characteristics of the functional state change in different directions and with varying degrees of severity due to the action of a variety of habitability factors and professional activities. Thirdly, the specific features of professional activity affect psychophysiological indicators, and this should be taken into account when planning and conducting medical rehabilitation for specialists of various profiles.
Russian Military Medical Academy Reports. 2019;38(4):85-88
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MILITARY EPIDEMIOLOGY: CURRENT STATE AND DEVELOPMENT PROSPECTS
Aminev R.M., Kuzin A.A., Zobov A.E.
Abstract
The article describes the main stages of the development of military epidemiology in the modern system of antiepidemic protection of troops, provides historical aspects of the evolution of forces and means of anti-epidemic protection of personnel. The current state and main directions of the develop-ment of military epidemiology as a science are determined. The problematic issues are outlined and the priority tasks of improving the system of antiepidemic defense of the troops are outlined. In order to improve the system of antiepidemic protection of troops, it is necessary: to focus on ensuring the sanitary and epidemiological well-being of problematic military units and garrisons; ensure the objectification and automation of epidemiological surveillance based on the introduction of modern equipment and laboratory techniques, as well as modern computer technologies; to study the issue of expanding the spectrum of infections within the framework of the Calendar of preventive vaccinations according to epidemic indications to the military personnel of the Armed Forces of Russia (for example, against acute intestinal infections, adenovirus infection, etc.); carry out the development and implementation of new technical means of prevention and control of infectious diseases, as well as emergency and immunoprophylaxis; improve the means and methods of biological defense of troops; develop and update the regulatory framework. The functioning of the Armed Forces of the Russian Federation in modern conditions poses new challenges for military epidemiologists, the solution of which should bring military epidemiology, as well as an antiepidemic support system for the army and navy, to a qualitatively new level of development.
Russian Military Medical Academy Reports. 2019;38(4):89-92
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EXPERIENCE IN IMPLEMENTATION OF NEW TECHNOLOGY OF PREPARATION AND EARLY PRIMARY PROSTHETICS AFTER LIMB AMPUTATION IN REHABILITATION OF VICTIMS AT TRAUMAS AND WOUNDS OF PEACE AND WAR TIME. POSSIBILITIES OF APPLICATION OF IMPORT-SUBSTITUTING TECHNOLOGIES IN CLINICAL PRACTICE
Shcherbina K.K., Samokhvalov I.M., Chupryaev V.A., Suslyaev V.G., Borisov M.B., Zamilatskiy Y.I.
Abstract
The article presents the experience of introducing a new preparation technology and early primary prosthetics after amputation of limbs in the rehabilitation of victims of injuries in peacetime and wartime and the possibility of using import-substituting technologies in clinical practice. The problems of primary prosthetics as an integral part of medical rehabilitation of patients after amputation of the lower limb are very relevant in many countries of the world due to the increased terrorist threat and a large number of local conflicts and road transport and occupational injuries. Regulatory documents establish the terms of early prosthetics up to one year after amputation. The technology of early restoration of the ability to move independently contains several successive stages of the coordinated work of the clinics of the Military Medical Academy and the G. A. Albrecht Center. Rehabilitation measures in the clinics of the Military Medical Academy with the participation of specialists from the G. A. Albrecht Center provides an example of successful interagency collaboration that promotes successful early rehabilitation of critically ill people. The developed technique of early prosthetics can be used to form a mobilization reserve in hospitals of the Ministry of Defense of the Russian Federation.
Russian Military Medical Academy Reports. 2019;38(4):93-95
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SOLDIER’S HEALTH AS A MEDICAL, PSYCHOLOGICAL AND SOCIAL PROBLEM
Soshkin P.A., Belov V.G., Zabrodskiy D.S., Redkin E.E.
Abstract
The health of servicemen is not only a medical and biological category, but also a psychological and social one. Performance of the military personnel of the biological and social functions can be interpreted as manifestations of health. From the correspondence of life attitudes, claims and manifestations of health, one or another degree of well being-physical, mental and social-is formed. In this regard, it can be argued that the health of the soldier is a complex medical, psychological and social phenomenon and its preservation should be carried out from a systemic perspective at these levels. The concept of “health” does not have a universally accepted unified interpretation, is characterized by the ambiguity and heterogeneity of the composition. According to the definition that was given in the preamble of the Charter of the World Health Organization (WHO) in 1948, health is a condition of a person who is characterized not only by the absence of diseases or physical defects, but also complete physical, mental and social well-being. It can be concluded that health is an integral characteristic that reflects the influence of various conditions (both external and internal environment) on the success of adaptation and professional activities of military personnel. The health of a serviceman is a complex medical-psychological-social phenomenon, and its preservation should be carried out from systemic positions at the indicated levels.
Russian Military Medical Academy Reports. 2019;38(4):96-98
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SPECIFICS OF INTERNAL PICTURE OF HEALTH OF THE MILITARY PERSONNEL
Soshkin P.A., Belov V.G., Zabrodskiy D.S.
Abstract
The following components can be distinguished in the structure of the personal semantic system “internal picture of health” in servicemen: cognitive, emotional-evaluative and behavioral. Taken in the system, these structural components realize information and regulatory functions, as well as the function of emotional reinforcement. The strategic task of military medicine in the field of preserving and strengthening the health of military personnel as a psychological and social phenomenon is the formation of their personal system of meanings “internal picture of health”. It should be noted that the transformation of the psychological and social content of the phenomenon of “health” into the meaning of the life of a particular soldier is possible only with a personality-oriented semantic system “internal picture of health”, which should become the core and generalized dynamic semantic system responsible for the general orientation of life as a whole. The strategic objective of military medicine in the field of preserving and strengthening the health of a serviceman as a psychological and social phenomenon is the formation of a personal system of meanings “internal health picture” of resource-pragmatic and personality-oriented levels in conjunction with the improvement of their vitality at the psychophysiological and socio-personal levels. The tactical task of military medicine in the field of preserving and strengthening health as a psychological and social phenomenon is the formation of active dynamic semantic system of readiness for optimization of vitality among military personnel.
Russian Military Medical Academy Reports. 2019;38(4):99-101
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ASSESSMENT OF SATISFACTION OF MILITARY PENSIONERSBY SOME TYPES OF MEDICAL AID
Petryakhin D.N., Ivanov V.V.
Abstract
In modern conditions, the provision of medical care to people of older age groups is an important task of the state. The life expectancy and working ability of our pensioners directly depends on this. Therefore, the study of various aspects of the provision of medical care to military pensioners is relevant and important. To collect information, the questionnaire method was used. The satisfaction of military retirees with dental care was evaluated on the basis of a study of questionnaires specially designed at the Department of Automation of Management of the Medical Service (with military medical statistics) of the Military Medical Academy. The questionnaire contained questions characterizing the criteria of openness, accessibility, comfort of the conditions for the provision of services. Military pensioners had to evaluate their satisfaction with the work of the dental clinic and organizational issues. On the basis of the multidisciplinary clinic of the S. Kirov Military Medical Academy, patients at the dental clinic underwent anonymous questioning. An analysis of the questionnaires of military pensioners who applied for dental care in 2019 was carried out. Data were received on the satisfaction of military pensioners with the medical service provided. The data obtained allow us to conclude that a total of 93% of military pensioners who applied to the Military Medical Academy for dental care are satisfied with the service provided. At the same time, it is necessary to pay attention to such issues as: ensuring the convenience and accessibility of obtaining medical services; the availability of information about the appointment procedure; organization of work of the registry; adjustment of navigation taking into account the age of the contingent (military pensioners).
Russian Military Medical Academy Reports. 2019;38(4):102-104
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ASSESSMENT OF MORBIDITY OF SERVICEMEN OF THE AIR DEFENSE BRIGADEOF THE ARMED FORCES OF THE REPUBLIC OF KAZAKHSTAN
Kasimov N.Z., Savchenko I.F., Troshko I.V., Bezborodov A.N.
Abstract
The paper analyzes the morbidity of servicemen of various units of the air defense brigade of the Armed Forces of the Republic of Kazakhstan. Developed and proposed reasonable ways to reduce the incidence of personnel units of the air defense brigade of the Armed Forces of the Republic of Kazakhstan. The assessment of the health status of military personnel was based on the results of an in-depth analysis of morbidity with temporary disability (VUT). The negative influence of performance factors on the health indicators of military personnel was revealed. 71.6% of the military were sick during the study period, and only 28.4% were not sick. The stress of the body associated with the stress gene situation affects the general resistance of the body of the military, which is manifested by an increase in the overall incidence with temporary disability. In the structure of morbidity, the leading place is occupied by diseases of the respiratory system (44%), organs of the cardiovascular system (21%) and digestive organs (18%), infectious diseases - 4%, genitourinary diseases - 3% and nervous diseases - 7%. The creation of appropriate living conditions for the deployment of personnel, the provision of appropriate warm clothing and footwear, as well as adequate nutrition, will generally have a positive effect on the incidence (significantly lower level) of the air defense forces. By organizing appropriate control, the medical service will have the opportunity to deliberately influence the level of possible sanitary losses by patients during reconnaissance and information actions when performing tasks for their intended purpose.
Russian Military Medical Academy Reports. 2019;38(4):105-107
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IMPROVEMENT OF REQUIREMENTS FOR MOBILE FIELD X-RAY SYSTEMS
Naumov A.V., Yudin A.B., Lopatin S.A.
Abstract
When providing medical support for military operations, an important component is diagnostic measures, among which one of the main places is X-ray diagnostics, which is necessary as soon as possible for injuries and injuries, which are characterized by a wide variety of damage to organs and systems, the severity of the course and the high probability of adverse outcomes. In the light of these ideas, it is important to use modern approaches to the development of tactical and technical requirements for mobile field x-ray systems. Experience in the field of technical equipment of the medical service showed that mobile means of radiation diagnostics need further improvement. For this purpose, 4 groups of indicators have been developed that have been successfully used to evaluate a new field X-ray apparatus. When assessing functionality using a 4-point scale, experts gave a higher rating to the MobiRen-4MT apparatus, especially in the following indicators: the ability to perform a series of images, the ability to study any anatomical areas. The ARA 110. 160-02 is inferior to MobiRen-4MT in terms of the latest indicator, since it is difficult to perform radiological diagnostics of abdominal organs and lumbar spine in the field when examining full faces. Also, for the better, the MobiRen-4MT device differs in terms of indicators: completeness of research, safety for patients, and ease for patients.
Russian Military Medical Academy Reports. 2019;38(4):108-110
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THE LEGAL STATUS OF MEDICAL ORGANIZATIONS OF THE RUSSIAN FEDERATION
Tegza V.Y., Aksenov A.S., Redkin E.E.
Abstract
The legislative regulation of the legal status (status) medical organization is carried out both federal laws and legal regulations. Medical organizations like nonprofits, firstly, perform socially important functions, and secondly, they do not have as a primary objective of its profit-making activities. However, these organizations can implement and aimed at profit-making business, but only insofar as it contributes to the objectives for which they were created. The first step in the structural reform of domestic health care was to change the legal form of state and municipal medical organizations, which were divided into three types: state, budget and autonomous. Of the listed types of institutions, an autonomous state institution is granted the widest freedom in attracting and managing funds received from activities that do not go beyond the scope of special legal capacity. Modern organizational and legal forms of medical organizations require correction due to the fact that none of the above forms of institutions is ideal for medical activities in the Russian Federation. The development of an innovative model of the legal form of a medical organization is the most urgent task of the Russian Federation for the coming years.
Russian Military Medical Academy Reports. 2019;38(4):111-114
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USING THE POTENTIAL OF A STATE-PRIVATE PARTNERSHIP FOR THE DEVELOPMENT OF NEW SAMPLES OF MEDICAL EQUIPMENT
Yudin A.B., Naumov A.V., Lopatin S.A.
Abstract
One of the promising mechanisms for the defense industry complex, including the production of medical equipment, is considered to be a public-private partnership, based on extra-budgetary funding, since the dominant positions in the domestic industry, as well as in the economy as a whole, are occupied by private company. Experts predicted that the defense industry could become a pilot platform for developing interaction between the state and business in the innovation sphere, as in the defense industry, high-tech products are provided with stable state demand and the prospects for the development of the complex are determined in the adopted programs. The practical implementation of plans to create new medical supplies under extreme conditions will be largely determined by the completeness of the subordinate regulatory framework and the amount of financial resources that the state is ready to allocate through various channels to support the relevant subjects of industrial activity. The practical implementation of plans for the creation of new medical supplies under extreme conditions will be largely determined by the completeness of the sub-legislative regulatory framework and the amount of financial resources that the state is ready to allocate through various channels to support the relevant subjects of industrial activity. Domestic manufacturers in almost all sectors have underloaded production capacities and therefore are able, especially with the assistance of the state, implemented under the existing legislation on industrial and investment policies, to increase the output of military products in the required time frame.
Russian Military Medical Academy Reports. 2019;38(4):115-117
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MODERN INFORMATION TECHNOLOGIES IN THE ORGANIZATION OF MEDICAL SUPPORT OF THE TROOPS (FORCES)
Ivanov V.V., Borisov D.N., Sorokin S.I.
Abstract
The medical service of the Armed Forces of the Russian Federation and large military medical organizations are developing various components of information technology designed to improve the medical support of military personnel and other attached contingents of the population. On the basis of the multidisciplinary clinic of the Military Medical Academy, a distributed data transmission network, a data processing center, a medical information system and highly specialized systems are being developed for the needs of certain areas of medicine. The coordination center for medical support realizes the needs of the practical application of information technology in the medical service of the Armed Forces of the Russian Federation. Technologies for coordination of donation and transplantation of human organs and tissues, a system of remote telemedicine consultations and a unified medical information system based on the automated Passport system are being developed. In the interests of the activities of the entire medical service of the Armed Forces of the Russian Federation, work continues on the creation of interactive software products based on geoinformation systems that allow modernizing information services for managing subordinate units and organizations. In the interests of the military command and control system, automation processes are developing in the field of standard design tasks, as well as artificial intelligence systems for making management decisions in the field of unstructured and weakly structured data. There is no doubt that the role of information technology in the management of medical support for troops (forces), the provision of medical and diagnostic assistance in military medical organizations will only increase, and the medical service of the Armed Forces of the Russian Federation must adopt the most advanced experience and comply with the trends in the development of informatization in domestic health care
Russian Military Medical Academy Reports. 2019;38(4):118-121
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APPLICATION OF ARTIFICIAL INTELLIGENCE AT THE ORGANIZATION OF TREATMENT AND DIAGNOSTIC EVENTS
Borisov D.N., Kul›nev S.V., Sevryukov V.V., Troshko I.V., Lemeshkin R.N.
Abstract
Automated image analysis and pattern recognition using artificial intelligence is increasingly being used in various fields of science and practice. In the field of medicine, the use of artificial intelligence based on neural networks of various types has found its application in the analysis of digital diagnostic images, mainly in the field of radiology and radiology. The main criterion that determines the effectiveness of the application of artificial intelligence technologies is the degree of sensitivity and specificity of the method, i.e. the percentage of true positive and true false results. In this case, the final decision on the application of diagnostic results using artificial intelligence is made only by a medical specialist who bears medical and legal responsibility for treating a patient. In this case, the main form of application of artificial intelligence in medicine is the formation of systems for making support for medical decisions in medical information systems. The development of diagnostic and medical decision support systems based on neural networks is actively developing. This is due to improved diagnostic accuracy and reduced time required for its implementation. The accuracy of existing systems reaches 97%, but at the moment there is no single diagnostic SPPVR compatible with the information systems of medical organizations. In conditions of active informatization of military health care, the development of a unified medical information system for the military medical service and EHISS, the introduction of AI elements in clinical practice will ensure the unification and standardization of diagnostics, and will improve the quality of the treatment and diagnostic process in the units, units and organizations of the medical service of the Armed Forces of the Russian Federation.
Russian Military Medical Academy Reports. 2019;38(4):122-125
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IMITATION MODELING OF ACTIVITIES OF A FIELD MEDICAL ORGANIZATION (ON THE EXAMPLE OF A MEDICAL COMPANY OF A BRIGADE)
Kulnev S.V., Borisov D.N., Kushnirchuk I.I., Troshko I.V., Volkova Y.Y.
Abstract
Simulation of the work of medical organizations is becoming an important tool for evaluating the activities and throughput of departments, parts and institutions of the medical service, as well as evaluating the use of their resources. A field medical organization is a universal facility for providing various types of medical care outside of stationary facilities, both in situations of military conflict and in the liquidation of the health consequences of an emergency. It was revealed that the use of simulation tools allows you to more flexibly evaluate various parameters of the field medical organization. When creating an adequate model that takes into account all the resources of a medical organization, it is possible to simulate various flows of the wounded, sick and injured and offer options for organizational decisions in terms of the amount of assistance provided and the need to attract additional resources in various functional units. To model the field medical organization, we took as a basis the structure and staff of the medical company brigade. The movement of patient information flows from the reception and sorting department to the evacuation department was simulated. About 50% of all incoming patients fell into the marshalling room for lightly wounded. The proportion of seriously wounded and wounded moderate was about 35%. Modeling allows predicting the flow rate of patients, the use of resources of the field medical organization, as well as determining the possibility of maneuver by forces and means of the medical service. It is advisable to further develop the modeling system in the medical service of the Armed Forces of the Russian Federation, create models of typical field medical organizations, as well as a medical and evacuation support system consisting of various field medical organizations as a whole.
Russian Military Medical Academy Reports. 2019;38(4):126-129
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POSSIBILITIES OF APPLICATION OF MODELING SYSTEMS IN THE INTERESTS OF MEDICAL SUPPORT OF TROOPS
Kulnev S.V., Borisov D.N., Kushnirchuk I.I., Lemeshkin R.N., Zhukov A.A., Troshko I.V., Bolgarev D.V.
Abstract
Simulation of the work of medical organizations is becoming an important tool for evaluating the activities and throughput of departments, parts and institutions of the medical service, as well as evaluating the use of their resources. A field medical organization is a universal facility for providing various types of medical care outside of stationary facilities, both in situations of military conflict and in the liquidation of the health consequences of an emergency. It was revealed that the use of simulation tools allows you to more flexibly evaluate various parameters of the field medical organization. When creating an adequate model that takes into account all the resources of a medical organization, it is possible to simulate various flows of the wounded, sick and injured and offer options for organizational decisions in terms of the amount of assistance provided and the need to attract additional resources in various functional units. It is determined that a promising system for modeling medical support should use the capabilities of mathematical and simulation (discrete event and agent) modeling. The most promising direction of modeling the forces and means of medical services during treatment and evacuation support is the use of discreteevent simulation of medical support in the provision of medical care, removal (removal) of the wounded, sick and injured, the use of forces and means of medical service, the work stages of medical evacuation.
Russian Military Medical Academy Reports. 2019;38(4):130-132
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APPLICATION OF TELEMEDICAL TECHNOLOGIES IN MILITARY MEDICAL ORGANIZATIONS UNDER THE PROVISIONOF MEDICAL AID IN FIELD CONDITIONS
Sorokin S.I., Gyzeev R.N., Borisov D.N., Sivashenko P.P.
Abstract
The results of the use of telemedicine technologies in military medical organizations in the provision of medical care prove the effectiveness of their use. In the course of medical research exercises with medo (SpN) using a mobile telemedicine complex, telemedicine consultations and diagnostic studies in real time were carried out. An analysis of the results obtained during the provision of medical care in the field revealed a number of features of the use of telemedicine technologies. The development of telemedicine technologies in recent decades provides new opportunities for their use in the practice of military health care, including the work of military medical organizations in the field. At present, phased systematic equipping of work of military medical organizations with hardware and software systems “Remote Telemedical Consultations System” is being carried out. An analysis of the results of studies on the use of telemedicine technologies in the field of medical care showed that organizing and conducting remote consultative assistance in all forms (emergency, emergency, planned) requires at least two prepared places for equipping a subscriber telemedicine point with an access point to services communications, one of which is equipped in the intensive care unit (anti-shock chamber), and the placement of medical equipment of the agricultural industrial complex SUTK in the structural unit work of military medical organizations eniyah in accordance with the intended use.
Russian Military Medical Academy Reports. 2019;38(4):133-136
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PROSPECTS INTEGRATION OF ACTIVITY MEDICAL SERVICE OF ARMED FORCES OF THE RUSSIAN FEDERATION WITH A UNIFORM DIGITAL CONTOUR IN HEALTH CARE
Gasparyan O.V., Guzeev R.N., Leonidov A.B., Demidovich E.A., Sorokin S.I.
Abstract
The article is devoted to the prospects of integrating the activities of the medical service of the armed forces of the Russian Federation with a single digital circuit in healthcare. The federal project provides for the creation of a threetier system of the Digital Circuit in healthcare: medical organizations (medical information systems), public health authorities of the constituent entities of the Russian Federation (regional health information systems) and the Federal EHISC segment. The prospects of providing information support for the daily activities of the medical service of the Armed Forces of the Russian Federation, increasing the efficiency of the military command and control bodies through the integration of digital platforms, which significantly reduce the time for making managerial decisions by officials at all levels, are estimated. Based on the results of monitoring the implementation of information products in the Armed Forces of the Russian Federation, as well as the analysis of the implementation of the Federal project “A single digital circuit in healthcare” in the constituent entities of the Russian Federation, an increase in the number of medical information systems introduced in the military-medical sector is expected to be most likely in the medium term organizations. Based on the results of monitoring the implementation of information products in the Armed Forces of the Russian Federation, as well as the analysis of the implementation of the Federal project “A single digital circuit in healthcare” in the constituent entities of the Russian Federation, an increase in the number of medical information systems introduced in the military-medical sector is expected to be most likely in the medium term organizations.
Russian Military Medical Academy Reports. 2019;38(4):137-140
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EXPERIENCE IN CONDUCTING FIELD TRIALS (ASSESSMENT AND TESTING) MODELSOF PORTABLE NON-INVASIVE MONITOR IN THE FIELD
Shatilo Y.V., Bezboodov A.N.
Abstract
During the exercises of the Central Military District Center-2019 at the Donguz training ground from 08.27.2019. On August 30, 2019, field trials of a prototype portable non-invasive monitor were conducted. Portable non-invasive monitor (PNM) is designed for operational continuous monitoring of vital parameters of patients in transport and field conditions. PNM allows continuous non-invasive measurement of blood pressure, ECG, pulse oximetry. The invasive method of determination has known limitations, especially in the conduct of combat operations, evacuation of the wounded and injured to further stages of medical evacuation, which stimulated the development of devices for non-invasive control. The use of PNM in combat conditions and during evacuation will allow continuous assessment of the functional state of the wounded and injured at the stages of medical evacuation. The monitor confirmed the ability to perform its functions as intended: the packaging and installation of the device is convenient for carrying by a shooter as a nurse; installation of sensors on the wounded is convenient and takes no more than 2 minutes in the summer; pulse oximetry and ECG work steadily in the process of transporting the wounded along field roads; the connection of the registration modules with the display module is stable in one room or in an open area. The created medical protocol is suitable for assessing the functional state of the injured and affected at the stages of medical evacuation. The selected instrument construction concept a system of registration modules and an indication module combined by a wireless interface effectively fulfills its purpose and is convenient for practice.
Russian Military Medical Academy Reports. 2019;38(4):141-143
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USE OF INFORMATION AND COMMUNICATION TECHNOLOGIES IN INTERACTIVE TEACHING METHODSIN MEDICAL EDUCATIONAL INSTITUTIONS
Sukhanov L.V., Ignatenko V.B., Tadzhibov N.M.
Abstract
The technological process of training is based on the receipt and transformation of information, so any pedagogical technology can be called information technology. Currently, with the help of information and communication technologies, teachers of medical institutions can create and conduct exclusive classes, attracting students to their development. The use of the latest technologies simplifies the perception of the material being studied, which means that it positively affects the effectiveness of the educational process. The article deals with the possibility of using business games in the training of medical students. To prepare graduates of this level, it is necessary to revise the system of traditional education in medical universities, develop new approaches and methods in higher medical education, where educational modeling using information and communication technologies plays a significant role through diagnostic and therapeutic tasks, problem situations, and especially educational business games, which allow to bring as close as possible students to real clinical practice. Ultimately, the use of information and communication technologies in the educational process in general and in the professional activity of a teacher of higher education is an integral element of the development of education in the context of an emerging information society. Information and communication technologies fill the educational process with new content, allow students to develop new skills and competencies, and the teacher to conduct classes at a higher quality level.
Russian Military Medical Academy Reports. 2019;38(4):144-147
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INTELLECTUAL ANALYSIS SYSTEMS OF MEDICINE INFORMATIONAS MAIN ASSISTANT OF RADIOLOGIST
Lemeshkin R.E., Blinov V.A., Bagrova A.A., Borisov D.N., Sivashenko P.P.
Abstract
Digital analysis technologies and synthesis of data are very important in modern clinical practice. Innovative areas of medical science are also associated with an increasing flow of data and the discovery of new nosological forms. Processing information is the most important part in researching of normal and pathological structure and functions internal organs. Digital analysis technologies also apply to support a diagnosis decision, curative manipulations and warnings of potentially dangerous changes in the health status of patients. Despite the fact that neural networks were introduced into medicine in order to completely replace a specialist at the stage of diagnosis, the need for a doctor to participate in this process is undeniable. The most important option for using neural networks in medicine is the ability to create a logic circuit. The doctor receives information about the patient during a direct examination of the patient. The artificial neural network gives the result - the diagnosis, but the final decision-making right remains with the doctor. The information retrieval system in this scheme stands in order to compensate for the possible lack of knowledge of the doctor in complex and rare clinical cases and acts as a consultant. It is possible to use these algorithms in organizing medical support for the daily activities of troops (forces) with the widespread introduction of telemedicine technologies.
Russian Military Medical Academy Reports. 2019;38(4):148-150
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FEATURES OF THE DEPLOYMENT OF SPECIAL MEDICAL UNITSIN COUNTER-TERRORIST OPERATIONS ON THE TERRITORY DAGESTAN IN 1999
Ivantsov V.A., Tegza V.Y., Yrazmambetov R.T., Tchalykh S.N.
Abstract
In the course of the study, information on planning the medical support of counter-terrorism operations was studied, analyzed and generalized. In the course of the research work, the main problematic issues in the planning of the medical support of the counter-terrorist operation were uncovered, which must be paid special attention in the process of preparing the medical service for the fulfillment of its mission. The organization of medical support and the provision of qualified medical care was planned to be carried out by deploying three special-purpose medical units in the territory of Dagestan. The deployment of omedo in accordance with the operational-tactical formation of the troops has shown its effectiveness in providing qualified medical care. 529 omedo, being constantly in the city of Kaspiysk, allocated surgical groups and groups of anesthesiology and intensive care in the Botlikh, Kadarsky and Khasavyurt directions. 323 omedo from Kizlyar advanced to Scarlet, then to Avtury and Shali. 66 omedo was deployed in Khasavyurt, and then in Khankala. At all stages, detachments were deployed and provided qualified medical assistance. Up to 85% of the wounded, qualified medical assistance was provided up to 6 hours, including 45,5% - up to 2 hours., And half of them during the first golden hours; 25,8% of the wounded received qualified surgical care in a period of 2 to 4 hours and only 13,6% - in a period of 4 to 10 hours due to the difficulty of evacuation in the mountains.
Russian Military Medical Academy Reports. 2019;38(4):151-153
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ABOUT MEDICAL AND SANITARY MAINTENANCE OF THE SOVIET TROOPS IN THE AREA OF LAKE HASSAN (1938)
Boldbaatar B., Savchenko I.F., Troshko I.F., Soldatov E.A.
Abstract
In the course of the study studied, analyzed and summarized available in open sources information on the results of medical support of the Soviet troops in the area of lake Khasan (1938). During the research work, the main problematic issues were revealed medical support of military operations of the Soviet troops in the area of Lake Khasan (1938), which should be paid special attention to in the course of work on the preparation of the medical service to perform the tasks intended. Despite a number of difficulties caused by the specific nature of the theater of operations and organizational shortcomings, the adopted system of staged evacuation and treatment of the wounded has shown its effectiveness. A total of 16 thousand people were admitted to hospitals during the conflict. In addition, some of the slightly wounded and sick continued to be in parts. For the first time during military operations on Khalkhin Gol, ambulance aircraft were widely used, and specialized surgical care departments were created in the structure of evacuation hospitals. Thus, in 1939 there was a system of staged evacuation and treatment of the wounded, which was later applied on the fields of the Great Patriotic War.
Russian Military Medical Academy Reports. 2019;38(4):154-158
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MEDICAL SUPPORT PLANNING OF BELARUSIAN STRATEGIC OFFENSIVE OPERATION “BAGRATION” (1944)
Maliukh A.A., Savchenko I.F., Khaleev V.M., Troshko I.V., Sivashenko P.P.
Abstract
In the course of the study, information on the planning of medical support for the strategic offensive operation Bagration was studied, analyzed and generalized. In the course of the research work, the main problematic issues in the planning of medical support for strategic operations were revealed, which should be paid special attention in the process of preparing the medical service for the fulfillment of its intended tasks. As a result of mistakes (due to objective reasons) made during the planning of medical support for the strategic offensive operation Bagration, the location of the hospital bases of the fronts did not meet the objectives of the fronts during the strategic offensive operation. An important decision during the medical support of the operation was to approach the front line of the hospitals of the first echelon of the hospital base of the front, which can serve as an example of the correct and timely maneuver by the forces and means of the medical service when the situation changes. The study formulated conclusions. 1. The Belarusian strategic offensive operation “Bagration” was prepared in the conditions of secrecy and secrecy, characterized by a huge scope of actions of the troops, ambitious plans and, in this regard, planning was carried out in conditions of a lack of information on the composition of the troops, the direction of the attacks, which in turn led to the lack of interaction not only between the fronts, but also between the armies. 2. The planning of medical support for the strategic offensive operation Bagration and the training of forces and facilities of the medical service of the fronts were negatively affected by the lack of a coordinating role of the Main Military Sanitary Administration. 3. As a result of errors (due to objective reasons) made when planning the medical support of the strategic offensive operation Bagration, the location of the hospital bases of the fronts did not meet the objectives of the fronts during the strategic offensive operation. 4. An important decision during the medical support of the operation was to approach the front line of the hospitals of the first echelon of the hospital base of the front, which can serve as an example of the correct and timely maneuver by forces and means of the medical service in case of a change in situation.
Russian Military Medical Academy Reports. 2019;38(4):159-162
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MILITARY-HISTORICAL ASPECTS OF FORMATION ANDORGANIZATION OF WORK OF THE EVACUATION POINT (LOCAL)
Khamitov F.A., Zhukov A.A., Persiantsev V.V., Elizarev S.V.
Abstract
As a result of the analysis of available materials, the historical experience of the management bodies in the management system of the hospital base of the rear of the country in the framework of medical support of front-line operations of the great Patriotic war of 1941-1945 is analyzed. The conditions of modern warfare do not allow to concentrate in advance all the wounded and sick to be evacuated at loading points and require the organization of quick unloading of arriving wounded and sick and concentrating them far from the parking lots of vehicles. In this regard, when organizing the mass evacuation of the wounded and sick, the forces and funds allocated for its support should be located both at the places of loading (unloading) and at a point that ensures the concentration of evacuees or reception of arriving contingents. The composition of forces and means at the loading points and at the concentration (reception) point will be different and may vary depending on the situation and the tasks being solved. The evacuation (and especially mass) requires mandatory compliance with a number of general requirements, which, first of all, include a clear organization of medical triage, preparation of the wounded and sick for evacuation, urgent medical measures, loading and un-loading of the wounded and sick, evacuated with everything necessary and maintaining medical records.
Russian Military Medical Academy Reports. 2019;38(4):163-171
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FROM DEPARTMENT OF MILITARY AND MILITARY-SANITARY DISCIPLINES TO DEPARTMENT OF ORGANIZATION AND TACTICS OF MEDICAL SERVICE
Kulnev S.V., Shelepov A.M., Kryuchkov O.A.
Abstract
The article presents history of forming and activity of department of organization and tactics of medical service of S. M. Kirov Military-medical academy for the last nine decades on the base of wide historiographic material, archival sources and not published works. There were analyzed objective suppositions of creation of the department, process of teaching of military-sanitarium disciplines in form of separated courses, on departments of military and military-sanitarium disciplines and on a separated department of organization and tactics of medical service. There was scientific and pedagogic activity of the department, characterized it›s modem state and scientific strength. Department of Organization and Tactics of Medical Service - the leading theoretical department of the military medical profile at the Military Medical Academy. Her scientific interests are inextricably linked with those processes that occur in the medical service of the Armed Forces of the Russian Federation. It is on it that students receive fundamental knowledge on the organization of medical support for troops in peacetime and wartime. The faculty of the department makes a significant contribution to military medical science, to the organization of medical support for troops and the training of military medical personnel. The department has acquired a modern look and has become a methodological and scientific center for the medical service of the Armed Forces of the Russian Federation to develop the most pressing organizational problems of military medicine.
Russian Military Medical Academy Reports. 2019;38(4):172-177
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THE EXPERIENCE OF S. M. KIROV MILITARY MEDICAL ACADEMY IN THE COMPLEX-SHOWING CLASSES AT THE LUGA POLYGON
Lobachev I.V., Kulnev S.V., Redkin E.E., Zhuravlev V.K., Taranov S.P.
Abstract
The article analyzes the experience of participation S. M. Kirov Military Medical Academy in complex ostentatious classes at the Luga training ground. A positive assessment of the involvement of the Academy in the activities of interuniversity cooperation and combat training of the Western military district is given. The widely introduced involvement of military educators in activities of daily, combat and operational training of troops, in measures to combine the military-professional component of personnel training (conducting inter-university military games and tactical and special exercises, integrating the information and educational environment, etc.) shows its high efficiency. So, in accordance with the directive of the commander of the troops of the Western Military District, for the fourth time the faculty of the Academy and the students of the faculty of training doctors for the Missile and Ground Forces are involved in complex demonstrations dedicated to the Day of Missile Forces and Artillery and conducted by the Mikhailovsky Military Artillery Academy at the landfill in Luga. The participation of the Military Medical Academy in such events can be considered a positive experience in attracting our university to events of interuniversity cooperation and combat training of the district, during which educational, ostentatious and propaganda goals are achieved in training qualified military medical personnel.
Russian Military Medical Academy Reports. 2019;38(4):178-180
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PARTICIPTION OF 6TH YEAR CADETS IN DEPTH MEDICAL EXAMINATIONDURING MILITARI TRAINING
Khatinov A.M., Bezborodov A.N., Mirgorodskiy A.N.
Abstract
On December 29, 2018, the “Interim Instruction for the organization of medical examination, preventive and curative and health-improving measures, and clinical observation of the military personnel of the Armed Forces of the Russian Federation” was approved and entered into force. With this instruction, changes were made to the organization and procedure for conducting an in-depth medical examination of the military personnel of the Armed Forces of the Russian Federation. An in-depth medical examination of conscripted military personnel, as well as contracted military personnel (up to the unit commander and their peers), is carried out in medical companies (points) of military units, on the basis of outpatient departments (polyclinics) of medical military units (military medical organizations). The unit commander is responsible for providing the unit personnel for an in-depth (control) medical examination. A doctor of a military medical unit, unit or organization is responsible for the completeness and quality of an in-depth (control) medical examination of a soldier, as well as the preventive and therapeutic measures prescribed by him. Thus, the data presented allow us to conclude that the conduct of UMO in accordance with the requirements of the “Interim Instructions for the organization of medical examination, preventive and therapeutic measures, clinical follow-up of military personnel of the Armed Forces of the Russian Federation” allows us to give a more objective assessment of the state of health and identify a number of diseases in the early stages and take measures to prevent and treat them.
Russian Military Medical Academy Reports. 2019;38(4):181-184
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EXPERIENCE OF ORGANIZATION OF MEDICAL SUPPORT OF PERSONNEL OF THE NATIONAL GUARD OF THE REPUBLIC OF KAZAKHSTAN AT THE WINTER UNIVERSIADE IN ALMATY (2017)
Kaliev A.M., Savchenko I.F., Troshko I.V., Mirgorodskiy A.N.
Abstract
Properly organized and sustainable medical support for socially significant public events requires thoughtful preparatory work, which begins with an assessment of the management’s intentions, the characteristics of the location and working conditions of the personnel, the possible level of morbidity and injury, the specifics of the region and the region’s infrastructure, and the calculation of the forces and facilities of the medical service, early provision of a reserve of medical property. In the course of studying the experience of organizing medical support, the basic principles of managing the staged system of medical support for mass events were formulated. The most complete information on the interaction of the medical service of the National Guard of the Republic of Kazakhstan (NG RK) with other governing bodies was studied and summarized. The stages of separation of medical care were developed for the personnel of the involved forces and the population. The results of the analysis showed that therapeutic pathology (acute respiratory diseases) prevailed among the personnel, since the games took place in the winter. Moreover, the need for hospitalization was less than 50% of the number of sick employees. The injuries were sporadic and not severe. In the course of studying the experience of organizing medical support for mass sporting events, fundamental principles were formulated for managing the stage-by-stage system of medical support for mass events and organizing interaction with other special services, the scope of which includes measures to maintain public order and protect the life and health of the population. Guidelines were developed that regulate the activities of the medical service of the National Guard of the Republic of Kazakhstan.
Russian Military Medical Academy Reports. 2019;38(4):185-189
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SCIENTIFIC-PEDAGOGICAL SCHOOL OF DEPARTMENT OF ORGANIZATION AND TACTICS OF MEDICAL SERVICE OF S. M. KIROV MILITARY MEDICAL ACADEMY (TO THE 90TH ANNIVERSARY ACTIVITIES)
Biakov V.P., Kulnev S.V.
Abstract
The staff of the Department of Organization and Tactics of Medical Service celebrates a glorious anniversary - the 90th anniversary of faithful service to the Armed Forces of Russia. Over the years, the department’s personnel military medical organizers made a great contribution to the formation of the Red Army medical service in the prewar period, to the organization of medical care for the wounded and sick during the Great Patriotic War and in wars and armed conflicts after the war. The Department of organization and tactics of the medical service, celebrating its 90th anniversary, is the leading Department of the Academy, as well as the leading educational, methodological and scientific center of the Main military medical Department of the Ministry of defense of the Russian Federation. The article presents a historical overview of the teaching of military medicine in the Academy. At the department of Organization and Tactics of Medical Service, the founders and leaders of new scientific and pedagogical schools were the heads of the department (Leonardov, Georgievsky, Ivanov, Shelepov), senior teachers - heads of training courses, quite voluminous in subject and training time (Organization and Tactics of Medical Service Airborne Forces, Organization and Tactics of Medical Service Air Force, military medical geography). The creative atmosphere in the cathedral collective, the support by the department heads for initiative leaders of training courses, greatly facilitated their implementation. In turn, behind these officers there was often military experience, a rather lengthy military professional service in the troops (B. I . Kaputin, I. V. Aleksanyan). A. A. Shoshin served in Mongolia, participated in expeditions to the Far East, the Arctic and the Carpathians. The active joint activity of employees who are aware of their involvement in this scientific field contributed to an increase in the level of scientific work and the quality of teaching at the department as a whole.
Russian Military Medical Academy Reports. 2019;38(4):190-196
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ACADEMIC SCHOOL OF PROFESSOR EVGENIY VLADISLAVOVICH GEMBITSKIY (ON THE 100th ANNIVERSARY SINCE THE BIRTH)
Khalimov Y.S., Vlasenko A.N., Matveev S.Y., Pershin V.N.
Abstract
During a ten-year period of management of the Department of War Therapy E. V. Gembitskiy created the research-pedagogical staff of researchers, teachers, young instructors and post-graduates. The staff was distinguished by efficient academic activity, continuity of generations, recognition by the scientific and teaching communities. The Department conducted the work for e nhancing methodological support and educational means: the War Therapy textbook and a number of study guides and manuals were published. 7 dissertations for a doctoral degree and 24 dissertations for a candidate degree were defended under the supervision of the professor E. V. Gembitskiy.
Russian Military Medical Academy Reports. 2019;38(4):197-200
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3D-PRINTING IN MEDICINE
Lobanova M.I., Ovchinnikov D.V., Zheleznyak I.S., Peleshok S.A., Adamenko V.N., Mustaev O.Z.
Abstract
In order to identify trends and priority directions of using additive technologies in the interests of the military medicine development, a round table was held as part of the scientifi c and business program of the Army-2019 International Military-Technical Forum. The speeches of nine speakers of the scientifi c event are briefl y summarised. As a result of the discussion, the participants in the round table agreed that the results of scientifi c and innovative activities in the fi eld of 3D printing should be tested and implemented primarily in the educational process at the Military Medical Academy and the activities of the central military medical organizations for preoperative planning and manufacturing of medical devices. The use of additive technologies as one of the areas of personalized medicine will ensure a higher quality of medical care.
Russian Military Medical Academy Reports. 2019;38(4):201-206
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