Vol 38, No 1 (2019)

The analysis of the current state of obstetric and gynecological care in the Armed Forces of the Russian Federation, which revealed the main development trends and existing problems. It is determined that the number of female soldiers in the Armed Forces of the Ministry of Defense increases annually. 95% of all female military personnel are of reproductive age. Therefore, with regard to female soldiers, an additional task is the need to preserve reproductive health, the relevance of which is emphasized by the state demographic situation. The regulatory legal framework governing the organization of the provision of medical care to female military personnel has been established, is functioning successfully, is constantly being developed, is constantly being supplemented and updated. The priorities of the military medical organizations are defined: the elimination of personnel shortages; coverage of preventive medical examinations at least once a year of all women who are on medical support; optimal accessibility for female soldiers of primary health care (including in remote areas). Promising areas of development are: optimization and modernization of outpatient and inpatient obstetric and gynecological care for female military personnel; introduction into practice of the “Gynecological mobile complex” and “Individual hygiene kit for female soldiers of the Ministry of Defense of the Russian Federation”, which were developed by the staff of the Department of Obstetrics and Gynecology of the Military Medical Academy named after S. M. Kirov; prevention of oncogenic HPV infections in female cadets and young military personnel (reduction of risk factors, mass screening, vaccination with recombinant vaccines); development of assisted reproductive technology and telemedicine; improving the training of military specialists of obstetrician-gynecologists. Addressing priorities and improving obstetric and gynecological care in the Armed Forces of the Russian Federation will contribute to the achievement of the main targets in the field of health care - an increase in the total birth rate to 1.7‰, a decrease in infant mortality rates to 4.5‰ and mortality from malignant tumors to 185 percentiles (4 figs, bibliography: 24 refs).

The greatest difficulty is the situation with the unexpected occurrence of the center of mass sanitary losses. On the one hand, most of them occurring in large settlements with medical infrastructure in hospitals of medical institutions of the Ministry of Health of the Russian Federation, and other agencies, on the other hand, the capacity of these organizations always have the current load, often up to 100% of the most popular branches of its infrastructure - beds in the NICU and specialized hospitals for the treatment of acute poisoning. The infrastructure is separately taken to the medical institution, having in its composition a center of anesthesiology and intensive care when it is the current partial load, as a rule, is capable to accept simultaneously affected in case of group poisoning, however, the emergence of the chemical hearth of mass poisoning often paralyzes the whole system of rendering of medical aid to large cities as in the pre-hospital and fixed her link. At the same time, the treatment group of poisonings in non-core hospital also requires engagement or outreach health gain (in the presence of medical organizations that have been affected, sufficient forces and means for the organization of a full complex of diagnostic and treatment activities, taking into account the capacity of groups of amplification) or the expeditious medical evacuation of casualties to one or more medical organizations are able to perform the required scope of activities Toxicological assistance. (1 table, bibliography: 11 refs).

The article is devoted to a new drug- the first ARNI class (Angiotensin Receptor-Neprilysin Inhibitor) for the treatment of heart failure - a combination of sacubi tryl and valsartan, recently appeared on the pharmaceutical market, andalready included in the European recommendations in view of proven efficacy and safety. The article deals with the experience of using the combination of sacubitryl/valsartan in patients with cardiopulmonary pathology. The purpose of this article is to summarize the main steps leading to the development of a new treatment regimen for patients with severe heart failure. The article covers the history of the discovery of renin-angiotensin-aldosterone and natriuretic systems, as well as the mechanisms of their interaction. The questions of synthesis, secretion, clearance of vasoactive substances regulating these systems are considered. The diagnostic and prognostic significance of drugs aimed at various links of pathogenesis in patients with chronic heart failure was analyzed. Considered both positive and negative results of clinical studies, which in the end led to the creation of a new drug LCZ696, a first-in-class angiotensin receptor-neprilysin inhibitor. The results of the clinical study PARADIGM-HF were evaluated, and the practical and clinical significance of the possibility of using LCZ696 in different categories of patients was determined (bibliography: 11 refs).

According to statistics at the beginning of 2019, traumatic brain injury (TBI) is the most common type of injury and one of the main causes of disability in Russia. The main risk group are people, mostly men, aged 21-45 years. The consequences of injuries can be very different - from the banal headache characteristic of concussions, ending with complete disability in severe cases of TBI. The paper describes the clinical testing of the «SONOMED 315-R» echoencephalograph, produced by JSC “Spectromed”, as well as the feasibility of its implementation in the medical organizations of the Ministry of defense of Russia, given the high incidence of traumatic brain injuries and the actual lack of available to medical workers fast and accurate methods of diagnosis of dislocation syndrome. The device was used in the diagnosis of dislocation syndrome in 35 patients with combined traumatic brain injury and in 3 patients with brain tumors. Thus at victims with the combined trauma survey was carried out in various time intervals. This study reflects the current clinical and organizational promising directions to improve the results of treatment of the wounded (2 figs, 2 tables, bibliography: 14 refs).

The article is devoted to the largest russian surgical school created by an outstanding russian surgeon and scientist, the “father of russian urology,” a doctor of medical sciences, an honored scientist of the RSFSR, professor Sergey Petrovich Fedorov. The material describes the stages of the formation and development of a scientific school, its current state, and the prospects for its development The priority areas of practical and scientific activity of the scientific school of Professor S.P. Fedorov appeared: urology, biliary tract surgery, neurosurgery. The problems of abdominal and endocrine surgery, oncology, surgical infection, traumatology, anesthesiology, transfusiology and several others were also actively studied and developed. For almost 33 years, Professor S. P. Fedorov led the department and clinic of the Military Medical Academy, at the same time heading the Institute of Surgical Neuropathology since 1929, and during this time he prepared a brilliant galaxy of talented surgeons and scientists who continued to develop the ideas of the Teacher and glorify Russian medicine. Under the leadership of S. P. Fedorov 39 dissertation were defended: 36 doctoral and 3 candidate. Of dissertation, 13 were devoted to the problems of urology, 9 to abdominal surgery, 6 to neurosurgery, 8 to other areas of medicine (2 figs, bibliography: 4 refs).

June 23 of 2019 marks 100 years since the birth of Professor S. V. Ryzhkov, a prominent transfusiologist, the founder of the Russian Military Blood Transfusion Service, a pioneer of peritoneal dialysis and hemodialysis, the laureat of the USSR State Award for research into blood cells and bone marrow cryopreservation, a Stalingrad Battle combatant. S. V. Ryzhkov is a graduate of the Military medical Academy, a student of academician V. N. Shamov. S. V. Ryzhkov was one of the pioneers of the introduction into practice of methods of peritoneal dialysis and hemodialysis. In 1959, he headed the first research laboratory «Artificial kidney» organized in Leningrad, and in1961-the research laboratory of fibrinolysis blood and postmortem tissues. At present, the research laboratory fibrinolysis of blood and postmortem tissue reorganized into the Center (blood and tissue) of Military Medical Academy. He headed this laboratory for 20 years (1961-1981). He was the organizer of the blood service of the armed forces, developed the staff, structure, equipment, tasks of service in peacetime and wartime. S. V. Ryzhkov paid great attention to forecasting, planning, integration and implementation of scientific research on the problems of military Transfusiology. He justified the safety of donation of 400 ml of blood in the army. Developed issues of optimization of blood components and preparations, requirements to technical equipment of blood service, introduction of methods of hardware production of plasma and blood cells (platelets, leukocytes) from donors, transfusion of blood components in peacetime and wartime. His duties included organizational and methodological management of the blood service of the armed forces, coordination of its activities with the blood services of the Ministry of health, Civil defense and the Ministry of emergency situations, as well as the Warsaw Pact countries. He fostered 4 Doctors of Science and 14 Candidates of Science (1 figure, bibliography: 14 refs).