bluuebunny/crossref_metadata_2025 huggingface dataset:
Some aspects of pharmacological support with antidysrhythmic drugs
Authors: Archipov Vladimir V. , Bolsunovskaya Yuliya R.
Published: July 2021

A high level of morbidity and mortality from cardiovascular diseases remains prevalent in the Russian Federation, despite a decreasing trend that emerged in recent years. Rhythm and conduction disorders play an essential role in the thanatogenesis of cardiovascular pathology, which determines the medical and social significance of their pharmacotherapy. This is indicated by the stable demand for antidysrhythmic drugs from both the state and the population. This is evidenced by high levels of public procurements and retail sales of drugs for the treatment of cardiovascular diseases, since patients take this drug group for a long time and often permanently. Our marketing analysis of the antidysrhythmic drugs market used current open data from the State Register of Medicines and the State Register of Maximum Selling Prices and available analytical data. It showed that from 54.5% (metoprolol drugs) to 100% (procainamide drugs) of the market share is occupied by generic drugs made in Russia. The presented analysis confirms the assumption of a significant increase in the share of generic drugs in public procurements. This is associated with the implementation of the drug safety program for vital and essential drugs and the optimization of costs by the state. A priority of the state drug policy in Russia is to monitor the effectiveness and safety throughout its entire life cycle. Moreover, particular importance should be given to the issue of interchangeability, which is regulated by Federal Law No. 1360 dated September 5, 2020, On the Procedure for Determining the Interchangeability of Medicines for Medical Use. The annual increase in the share of generic domestic antidysrhythmic drugs on the market poses the problem of selecting the most efficient and safe approach to pharmacotherapy for practicing specialists. The solution may be to develop and implement open automated information systems for the safety profiles of the original and generic antidysrhythmic drugs.
A clinical case of the novel coronavirus (COVID-19) reinfection in a health care worker
Authors: Kovtyukh Irina V. , Gendlin Gennady E. , Nikitin Igor G. , Kabirova Ekaterina V. , Markina Olga Yu.
Published: July 2021

The peculiarities of immune responses to a novel coronavirus infection (COVID-19) and the possibility of reinfection due to the variability of humoral immunity are currently under discussion. This article presents a case of COVID-19 reinfection in a health care worker.
Characteristics of the etiological structure of infection associated with the provision of medical care in a multi-specialty hospital
Authors: Kotiv B N , Gumilevsky B Yu , Kolosovskaya E N , Kaftyreva L A , Orlova E S , Ivanov F V , Solov’yev A I
Published: July 2021

Epidemiological data on infections associated with medical care in surgical hospitals are presented. The features of the epidemic process of infections associated with Klebsiella spp. were studied among the patients of surgical profile. The study of the etiological structure in hemocultures in 33% of cases revealed the predominance of Klebsiella spp. In patients with a surgical profile, the incidence of Klebsiella spp. has increased over the past 10 years in wound content from 0,4 to 8,3% and in 7,7% of cases - in hemocultures. Significant resistance of Klebsiella spp. strains was detected currently used in the clinical practice of surgical hospitals antibacterial drugs. The highest sensitivity among Klebsiella spp. strains antimicrobial resistance was detected in the group of carbapenems. The structure of the epidemic process of infections caused by Klebsiella spp. is considered among patients of surgical clinics in 2018. In 32% of cases, the infectious process was localized in the lower respiratory tract, in 25% of cases - in the urinary tract, in 22% of cases - in the blood and in 21% of cases - in the area of surgical intervention. The results obtained do not differ significantly from the data obtained in other medical organizations in the country. The need for a comprehensive approach to microbiological monitoring and the appointment of antibacterial therapy for infections associated with the provision of medical care in surgical hospitals has been established. For example, the «Strategy for controlling antibacterial therapy» developed by the Russian Association of specialists in surgical infections, which is well-established in several dozen large hospitals in the country, is being more widely introduced into medical practice.
Clinical and economic rationale for the choice of treatment method for patients with kidney stones 10-20 mm
Authors: Protoshak V V , Tegsa V Yu , Paronnikov M V , Orlov D N , Alentiev S A , Lazutkin M V
Published: July 2021

The clinical and economic rationale for choosing a method of treating patients with kidney stones 10-20 mm in size is presented. Remote lithotripsy was found to be effective in 94,2% of patients whose urolitic density is less than 1000HU and in 81.6% of patients who have a stone density of more than 1000 HU. A «stone free state» with standard and mini- percutaneous nephrolitholapaxia was achieved in 93,5 and 94,1% in patients with a stone density of more than 1000 HU. Uroliths with a density of less than 1000 HU were removed in all patients using standard percutaneous nephrolitholapaxia and in 95% of patients using mini percutaneous nephrolitholapaxia. The smallest direct medical costs were observed when performing remote lithotripsy (patients with a density of uroliths less than 1000 HU - 24292,4 rubles, patients with a density of stones more than 1000 HU - 36930 rubles). When performing operations of standard and mini-nephrolitholapaxia, the cost of treatment was 38715,7 and 35900 rubles. for patients with uroliths with a density of less than 1000 HU, 40024 and37312,8 rubles. in patients with uroliths with a density of more than 1000 HU. The cost increment coefficient showed that additional costs of 1% of the treatment efficiency when using the minipercutaneous technique will require 30,6 rubles, with standard nephrolitholapaxy - 260 rubles per person compared with distance lithotripsy. From the standpoint of clinical and economic analysis, the mini-and standard percutaneous nephrolitholapaxia should be considered as reasonable methods for the surgical treatment of patients with high-density stones of 1-2 cm, remote lithotripsy is the first-line method for the treatment of calculi of lower density.
Modern Aspects of Etiological Diagnostics, Clinical Picture and Treatment of Severe Community-Acquired Pneumonia in Soldiers
Authors: Saluhov V V , Haritonov M A , Ivanov V V , Zhurkin M A , Chumak B A , Nikolaev A V , Rudakov Yu V , Asyamov K V , Bogomolov A B , Chugunov A A , Malceva O A
Published: July 2021

The problem of community-acquired pneumonia is one of the most relevant for military medicine. The relevance of community-acquired pneumonia is determined by the high incidence of conscription by military personnel, the severity of the clinical course, the presence of severe complications, the duration of labor losses, the tendency to epidemic spread, and the risk of deaths. It is necessary to improve laboratory research methods with the introduction of express methods for verifying bacterial and viral agents, determining the clinical features of the viral-bacterial pneumonia, and justifying the inclusion of antiviral agents in the etiotropic treatment regimen. An expanded complex of microbiological diagnosis of pneumonia has been developed, combining classical bacteriological methods with express methods (polymerase chain reaction, enzyme- linked immunosorbent assay, immunochromatography), which made it possible to determine atypical pathogens and viruses in addition to agents of a bacterial nature. Using these techniques, the modern etiological structure of community-acquired pneumonia in the military has been established, the prevalence of viral-bacterial pneumonia has been revealed. Among viruses, the leadership of adenovirus infection has been established, clinical and laboratory features of the disease are shown depending on the pathogens identified, the feasibility of additional prescribing of antiviral agents in addition to antibiotics in the treatment of viral-bacterial pneumonia is justified.
Features of assessing the quality of medical care for patients with prostate cancer in the late stages of the oncological process
Authors: Movchan K N , Chernov K E , Artyushin B S , Zharkov A V , Tatarkin V V , Chernova A Yu , Zheleznyy E V
Published: July 2021

Despite the successes in the examination and treatment of patients with prostate cancer, the problems associated with the organization of medical care for patients suffering from this disease remain. Defects in the verification of oncological diseases of the prostate often cause a decrease in parameters reflecting the quality and life expectancy of men. The data on the clinical case presented in the work demonstrate the difficulties of verifying a disease of a patient with prostate cancer, despite the involvement of many specialists of several medical institutions in the diagnostic process. With significant amounts of medical measures, the quality of the medical care provided at all stages can be considered inappropriate, primarily due to a violation of continuity in the management of the patient. Health care resources were used irrationally despite the fact that attempts were made to save the patient’s life at all levels and stages of medical care. Probably, defects in the provision of medical care could have been prevented by applying unified approaches in the diagnostic and treatment process using the advantages of information technology in modern computer databases of medical institutions, which make it possible to monitor the stages and volume of medical care provided to patients individually. In addition, the proper organization of medical care, as well as the targeted routing of patient flows should be provided not so much by clinicians as health managers. In the absence of opportunities in the treatment and prevention facilities, where patients are sometimes unplanned in urgent cases, the possibilities for carrying out diagnostic and treatment procedures, the healthcare organizers, together with the clinicians, must find reserves for referring patients to specialized medical organizations, in which examination and treatment of patients can be guaranteed. At the same time, the role, importance and effectiveness of the activities of health managers in the examination of the quality of medical care in each case should be evaluated separately.
Screening studies in the diagnosis of chronic carrier of the causative agent of the typhoid fever among residents of different countries
Authors: Kaftyreva L A , Porin A A , Ryzhman N N , Kolosovskaya E N
Published: July 2021

The results of screening studies of chronic carriage of the causative agent of typhoid fever (S. Typhi) among residents of various countries are presented. We studied 810 blood serums, including: 462 from citizens of the Republic of Guinea, 244 from labor migrants who arrived in the Russian Federation from Central Asia, and 104 from residents of St. Petersburg. Antibodies to S. Typhi Vi antigen were determined in the passive hemagglutination reaction as a marker of possible chronic carriage of bacteria. When screening studies of sera of citizens of the Republic of Guinea in 21 (4,5%) cases, a positive result was obtained. The level of antibodies to Vi- antigen above diagnostic was found in 6 (1,3%) sera. In 5 samples, the level of antibodies was 1:80, in one - 1: 160. Positive results in a screening study of the sera of labor migrants were obtained in 24 people. A confirmatory test revealed antibodies to the Vi antigen in the diagnostic titer in 9 sera. Positive results were obtained from 2 (3,64%) citizens of Tajikistan and 7 (4,09%) citizens of Uzbekistan. Antibodies to the S. Typhi Vi antigen were not found in residents of St. Petersburg (citizens of the Russian Federation). A comparable level of possible chronic carriage of typhoid fever was revealed for residents of epidemiologically unfavorable territories (Africa) and labor migrants coming to our country from Central Asia. The chances of the emergence of sources of infection in our country are increasing due to the increase in international contacts, which requires additional preventive measures.
About the prognosis of breast reconstruction quantity after mastectomy in cancer cases
Authors: Romanenkov N S , Movchan K N , Hizha V V , Zharkov A V , Morozov U M , Yakovenko O I , Gedgafov R M , Zheleznyj E V
Published: July 2021

The 5-year survival rates for women with breast cancer are steadily increasing. The number of cases of mastectomy for breast cancer is not reduced annually. In this regard, the analysis of epidemiological data on the observations of breast cancer in women in Russia seems to be an urgent activity in terms of predicting measures to optimize the volume of the recovery component of providing medical care to patients who have undergone mastectomy. It was established that in2017 in St. Petersburg the incidence rate of breast cancer reached 60,1100/. The parameter of the prevalence of malignant0000neoplasms of the mammary glands for the analyzed period exceeds the similar all-Russian by 19,3%. The frequency of casesof active detection of breast cancer in 2011-2018. increased 7,2 times. In the same period, the number of working-age urbanwomen diagnosed with breast cancer increased by 16,6%. The proportion of cases of verification of breast cancer of the I - IIstage of the tumor process in 2011-2018 increased by 1,2 times, reaching 72,2% in 2018. From 2011 to 2018, the growth of5-year survival of patients with breast cancer in St. Petersburg reached 4,9%, amounting to 63,4 in 2018% The parameterof annual mortality in breast cancer in 2011-2018 decreased by 30,6%. The performance indicators of the St. PetersburgOncology Service for the treatment of patients with breast cancer are comparable with similar parameters in Moscow clinicsand medical organizations in Russia as a whole. The increase in potential needs for prosthetics of the mammary glands dueto the increase in the number of patients with cancer who underwent mastectomy, in the future will necessitate the expansionof the high-tech types of medical care provided to patients suffering from malignant neoplasms of the mammary glands.
Trends in implementation of good practices in pharmaceutical organizations
Authors: Bidarova F N , Bidarov B S , Kostyuchenko O M
Published: July 2021

The level of knowledge and competencies of a graduate of a pharmaceutical university and specialist regarding the requirements of good pharmacy practice in pharmaceutical organizations of the Republic of North Ossetia-Alania is analyzed. A gap in the knowledge of graduates and specialists was identified and an author’s program for developing competencies for creating modern quality systems for pharmaceutical services and products was developed. The sample of the study was formed from the heads and pharmacists of retail pharmacy organizations of the Republic of North Ossetia-Alania of all forms of ownership, of which 38% were heads of a pharmaceutical organization, and the rest were pharmacists. Significant gaps and shortcomings of basic knowledge were identified among the management team, the main staff of pharmacists authorized for quality and implementation issues, as well as the creation of quality management systems in pharmaceutical organizations. Disadvantages associated with the lack of mechanisms for implementing the requirements of good pharmacy practice and the creation of a quality system in a pharmaceutical organization require action. So, it is necessary to develop modern educational modules that reflect the trends of modern transformations in the pharmaceutical industry. The low motivation of the staff of pharmaceutical organizations to improve their qualifications on the creation of quality systems was noted, due to the lack of basic knowledge among pharmacists and a sufficient amount of educational programs and modules. The author’s model of training specialists capable of creating modern quality systems in the pharmaceutical organization and the characteristics of the educational complex of the new discipline of choice are presented
Clinical aspects of providing specialized care to people burned after the disaster in Bashkiria in 1989
Authors: Stepanova T V , Sokolov V A
Published: July 2021

The contents of the organization of specialized medical care for those burned after a railway accident in Bashkiria in 1989 are investigated. Features of the evacuation and sorting of victims into various burn centers of the Union of Soviet Socialist Republics are described. The data on sorting and evacuation to various regions of the country are given. The materials on the statistics and structure of those who were burned from Bashkiria to medical institutions of federal significance are summarized. Information was collected from various primary sources on the number and structure of patients delivered to the burn clinics of the country. Information was obtained on the treatment methods applied to injured by medical teams of hospitals. The role of the decision of the leadership of the Ministry of Health in organizing the dispersal of a large number of burned, concentrated in Bashkiria, to the regional and federal medical centers of the country is emphasized. Information is given on the participation of both individual specialists, teams, and foreign states in assisting victims of the railway accident in Bashkiria. The significance of the accumulated scientific and practical experience is summarized in several scientific and practical conferences. So, they highlighted the issues of providing victims with medical care at the stages of evacuation, the provision of specialized medical care and rehabilitation at the hospital stage. They indicated that it is necessary to follow the provisions of the military medical doctrine and organize medical care on the principles of staged treatment.
Respiratory tuberculosis associated with chronic obstructive lung disease - actual problem of modern phthisiology
Authors: Katicheva A V , Brazhenko N A , Brazhenko O N , Zheleznyak S G , Tsygan N V
Published: July 2021

In modern conditions, the problems of tuberculosis of the respiratory system and chronic obstructive pulmonary disease are highly relevant. Tuberculosis remains high among the population. During its course, the frequency of common destructive forms, the number of patients with multiple and extensive drug resistance of mycobacteria, and comorbid conditions in which pulmonary tuberculosis is combined with immunodeficiency and respiratory pathology increased. Chronic tobacco intoxication and chronic obstruction in the lungs increase the activity of tuberculosis inflammation, contribute to the development of common forms of pulmonary tuberculosis, accompanied by abundant bacterial excretion and destruction of lung tissue. In patients with comorbid pathology, pronounced clinical manifestations of the disease, deep functional disorders in the respiratory system and homeostatic balance of the organism are determined. Chronic tobacco intoxication and chronic obstruction in the bronchi have a significant impact on the processes of atherogenesis, systemic inflammation, endothelial dysfunction and the formation of cardiovascular pathology. These phenomena contribute to insufficient treatment efficiency, the formation of pronounced residual changes in the respiratory organs, a decrease in the quality and life expectancy of patients, a high frequency of exacerbation (relapse) and pose a threat to the spread of tuberculosis. In patients with comorbid pathology, cardiovascular complications, dyslipidemia and atherogenesis appear much more often, which are predictors of early disability and premature death.
Senile eye cataract: medical and social aspects and the risk to public health
Authors: Javadova G Ch , Ioshin I E , Guliyeva S T
Published: July 2021

A review of literature data on issues related to the prevalence of cataract among the population and the possibilities of its treatment is provided. In 2010, there were more than 10,8 million people worldwide who completely lost their vision due to cataracts, and partially lost more than 35,1 million people. Currently, the growth rate of senile cataract is two times faster than the growth rate of the total population, and in industrialized countries - five times. The problem of the wide spread and severity of injury in cataracts, along with the medical one, also has a medical and social character, which is why worldwide attention is paid to the study of etiopathogenesis and treatment options for cataracts among people of working age. To date, cataract treatment involves only surgical removal of a clouded lens with implantation of an intraocular lens. More than 20 million such operations are carried out annually in the world. With the development of medical science and technological progress, new, more advanced surgical techniques are being developed, such as ultrasound and femtolaser phacoemulsification, which allow performing operations in the early stages of the disease and achieving better results in terms of visual acuity, avoiding the development of induced astigmatism, and reducing the likelihood of complications, including macular edema. However, despite the improvement of surgical techniques for cataract phacoemulsification, cases of postoperative complications are not uncommon. Thus, despite the study of the etiopathogenesis of cataracts and the development of advanced modern methods for its surgical treatment, the risk of complications remains. At the same time, the problem of preventing the development of macular postoperative edema is one of the main reasons for the decrease in visual acuity in operated patients. To reduce intraoperative complications, it is necessary to take into account risk factors, their combination, as well as improve the methods of their drug prophylaxis and treatment.
Experience with information and communication technology in mastering medical knowledge based on intelligence cards
Authors: Steshov A V , Zravinina N V , Yakovlev A G , Gilvanov P R , Kuzmin Yu P
Published: July 2021

We consider the information and communication technology of conducting classes using intelligence cards that meets the requirements of the modern subject-subject paradigm of education, which obliges one to be guided by the principle of communication. This principle implies significant changes in the organization of the process of interaction between the teacher and students in the classroom. The following parameters characterize such a technology for conducting a lesson: speech-cognitive activity, functionality, heuristic, motivated actions, the search for personal meaning in the work of students in the lesson. To implement these parameters in the educational process at A.F. Mozhaysky Military Space Academy. and S. M. Kirov Military Medical Academy used the capabilities of intelligence cards as a tool for information and communication technology. The innovation of the latter lies in the fact that the educational process is based on the active work of students both during the lesson and during the organization of their independent work, allowing them to effectively absorb educational information and subsequently apply it in practical activities. The study reflects the experience and describes an effective educational methodology using intelligence cards for lectures, practical classes, independent work of students and their research work. As an illustrative example, one of the developed intelligence cards is given and the methodological support of the lesson on the study of measures aimed at maintaining and strengthening the health of military personnel is described.
The Department of organization and tactics of medical service. Past, present, future
Authors: Kulnev V A , Shelepov A M , Kruchkov O A
Published: July 2021

The Department of organization and tactics of medical service, celebrating its 90th anniversary, is a leading department of our alma mater, as well as a leading academic and scientific centre of the Chief Military Medical Directorate of the Russian Federation Ministry of Defence. The department develops applied research tasks in the sphere of organization of medical service and provision of medical services to the Armed Forces of the Russian Federation in peacetime and wartime, engages in preparation of directive documents within its profile, analyses efficiency of medical services provided to the armed troops (forces) in daily activities of the medical service and in combat conditions. The department has always taken an active part in the development, preparation and conduct of research command-post and special tactical exercises in conjunction with the medical service of the Russian Federation Armed Forces, as well as in different stages, including the international stage, of the Military Medical Relay Competition jointly with the medical staff of military districts (fleets), branches and services of the Russian Federation Armed Forces. The department is engaged in serious work aimed at training qualified specialists for the overhead structures of the medical service of the Russian Federation Armed Forces, as well as military medics for the army. Over the 90 years of its existence, the department has developed into five new departments: department of military disciplines (operational- tactical training), department of organization and tactics of naval medical service (with a course of naval fighting equipment), department of medical service control automation with a course in military medical statistics, department of military medical supply and pharmacy, department of organization and economics of military healthcare. Among the significant achievements of the Department of organization and tactics of medical service is the development of a number of department-level training courses and academic disciplines some of which have turned (are turning) into independent departments, educational research schools.
Mikhail Kuzmich Geykin and his contribution to development of scientific and applied questions of maxillofacial surgery and stomatology (to the 120 anniversary since birth)
Authors: Iordanishvili A K
Published: July 2021

Materials on the history of military medicine are presented, maxillofacial surgery and dentistry in connection with the 120th birthday of a prominent maxillofacial surgeon and dentist, one of the patriarchs of Russian dentistry, a World War II veteran, doctor of medical sciences, assistant professor, colonel of the medical service Mikhail Kuzmich Geikin, who was at the forefront of Russian dentistry and was among the first to create Russian military dentistry and maxillofacial surgery. The data on the formation of M.K. Geikin as a military doctor, dentist and maxillofacial surgeon, his military career during the Soviet-Finnish and World War II. Turning to life, professional and social activities M.K. Geikin, you can find not only interesting scientific facts from the history of military medicine, dentistry and maxillofacial surgery, but also analogies with the present, answers to many clinical problems of the specialty and medicine of today. The main directions of his scientific activity, which touched on the issues of almost all sections of dentistry and maxillofacial surgery, are noted. Being the first adjunct of the Department of Odontology of the S.M. Kirov Military Medical Academy, a major research scientist, he contributed to the development of the first Russian theory of dental caries and the pathogenesis of periodontal diseases, one of the first to study the aviation aspects of military dentistry, and to develop new methods for temporary and therapeutic immobilization of jaw fragments in injuries and injuries of the maxillofacial region. He created a technique for intravital capillaroscopy and capillarography, did a lot for use in dentistry auriculodiagnostics and acupuncture, proposed a device for searching for biologically active points on the human body - tobiskop Geikina. M.K. Geykin did not create his own scientific school, but being one of the founders of Russian dentistry in Russia, including military dentistry and maxillofacial surgery, he should rightfully be recognized as one of the patriarchs of military medicine, dentistry and maxillofacial surgery.
The scientific legacy and reflections on the surgery of the prominent French Clinician Professor Rene Lerishe (to the 140th anniversary of his birth)
Authors: Morgoshiya T Sh , Apchel V Ya , Sasova V D
Published: July 2021

The scientific work of the outstanding French surgeon Rene Leriche is analyzed. Little-known facts from his life are noted. Lerish has published more than 1,200 scientific papers, including 21 monographs. Most of his works are devoted to problems of general and private clinical physiology and served as the basis for the establishment and development of the physiological direction in surgery. He investigated the problem of pain, in particular pain syndrome resulting from injuries; studied the possibilities of using surgical techniques for pathogenetic treatment. He was one of the first to propose the use of surgical interventions on the autonomic nervous system for the treatment of mainly peripheral vascular diseases. R. Lerish believed that the disease is not a distortion of normal, but the emergence of new physiological relationships. R. Lerish developed a technique for blockades and surgical interventions in the sympathetic department of the autonomic nervous system, including periarterial sympathectomy. He described the clinic in detail and proposed a method for surgical treatment of chronic occlusion of the terminal abdominal aorta (Lerish syndrome). R. Lerish attached great importance to the individual characteristics of a healthy person and indicated that doctors know little about a person during his illness. He was also worried by the fact that doctors know little why the disease takes one form or another, why the infection is virulent in one and benign in the other, while the contagiousness is the same. Lerish put forward in medicine the concept of individual pathology. He pointed out that the form of the disease depends on the organic personality of the person and does not depend on the type of infection. Referring to his impressions, Lerish said that he tried to search on this path, but found nothing but banality. For his work on the treatment of infected wounds, R. Lerish was awarded the Lister Medal (1939). He was the founder and first president of the European Society of Cardiovascular Surgeons; He was an honorary doctor of 30 foreign universities, an honorary member of several foreign academies and societies, including the All-Union Society of Surgeons of the Union of Soviet Socialist Republics.
Theodor Bil’roth - gastric surgery founder
Authors: Sigua B V , Zemlyanoy V P , Filenko B P , Kotkov P A , Danilov A M , Mavidi I P
Published: July 2021

More than a century has passed since the death of the great German surgeon Christian Albert Theodor Billroth. Despite such an impressive time, he is still widely known in the surgical community as the founder of gastric surgery, whose results of many years of work have largely influenced the development of abdominal surgery in the XIX-XX centuries. This person combined the features of a talented surgeon, teacher and organizer in equal measure. Thanks to strict adherence to aseptic rules, Theodor Billroth was the first to begin surgical interventions in anatomical areas, previously considered«forbidden» due to the high frequency of purulent-septic complications. Over the seven years he spent as head of the Zurich surgical clinic, the Billroth contributed to its significant expansion and modernization. He first introduced into the clinical practice statistics of surgical interventions and their results, thereby taking another step from the surgical craft to art and science. Being a versatile person, one of the brightest personality traits of Theodore Billroth was artistry, which was equally manifested both at the operating table and at the piano keyboard, because he, among other things, was a gifted pianist and violinist. In his life and work, he did not oppose science and art. As a scientist-innovator, professor Billroth was the first to perform successful interventions on organs previously considered to be inaccessible to operative effects, thus opening a fundamentally new page in the history of abdominal surgery.
Contribution of the staff of the Military medical academy to the development of peripheral nerve surgery
Authors: Gaivoronsky A I , Gubochkin N G , Churikov L I , Isaev D M , Alekseev D E , Legzdain M A , Averyanov D A , Svistov D V
Published: July 2021

The formation of the neurosurgical service in our country, as well as the development of peripheral nerve surgery, is inextricably linked with prominent figures - employees of the S. M. Kirov Military Medical Academy: L.M. Puseppa, V.N. Shamova, V.I. Grebenyuk, B.A. Samotokina, A.N. Solomina, E.I. Usanova, E.D. Alekseeva, F.S. Govenko, B.V. Martynova, A.E Belousova, etc. Already from the beginning of the 20th century, Ludwig Martynovich Pusepp has been actively engaged in the diagnosis and surgical treatment of peripheral nerve damage at the Imperial Military Medical Academy. In the second half of the XX century. peripheral nerve surgery undergoes an important stage: the transition to microsurgery. This stage is marked by the rapid development and implementation of microsurgical techniques in the treatment of patients suffering from traumatic lesions of limbs and nerves. The Academy is actively developing revascularization and reinnervation techniques for injuries to the limbs. Based on the analysis of the data of the Great Patriotic War and the war in Afghanistan, the Academy staff published works on the organization of medical care and surgical treatment of combat injuries of peripheral nerves. Thanks to the active scientific and practical work of A.E. Belousova, N.G. Gubochkina, E.D. Alekseeva, F.S. Govenko, B.V. Martynova at the beginning of the XXI century. Clinic of Neurosurgery of the S. M. Kirov Military Medical Academy becomes a leading institution in Russia, where they provide assistance to patients suffering from injuries and diseases of the peripheral nervous system.
Pofessor B.S. Uvarov - a patriot and defender of the Fatherland, founder of domestic military anesthesiology and resuscitation (to the 100th anniversary of the birth and to the 75th anniversary of Victory in the Great Patriotic War)
Authors: Levshankov A I
Published: July 2021

The main stages of the life and work of a military surgeon and anesthesiologist, Professor Boris Stepanovich Uvarov are presented. Professor B.S. Uvarov made an invaluable contribution to the formation and development of domestic military anesthesiology and resuscitation. After working for 12 years with his teacher, academician of the Academy of Medical Sciences of the Union of Soviet Socialist Republics P.A. Kupriyanov, on whose initiative the first department of anesthesiology in our country was created, becoming his successor, B.S. Uvarov made every effort to establish domestic military anesthesiology and resuscitation. For 23 years he was the head of the department of anesthesiology and intensive care at the S.M. Kirov Military Medical Academy, non-staff assistant to the chief surgeon (1964-1968) and deputy chief surgeon for anesthesiology and intensive care (1976-1986) of the Ministry of Defense of the Union of Soviet Socialist Republics. As a dissertation, scientific adviser or consultant, B.S. Uvarov completed 24 candidate and 7 doctoral dissertations in three main areas: 1) express diagnostics and monitoring of the condition of a patient in critical condition; 2) improving anesthetic and resuscitation care; and 3) organizing anesthetic and resuscitation care in the Armed Forces. He realized the problem of organizing anesthetic care in the light of the demands of military medicine. The implementation proposed by B.S. Uvarov, systems of anesthesiological and resuscitation care in the Armed Forces in peacetime, is reflected in the textbook «Anesthesiology and Resuscitation» (1979) and other published materials. Boris Stepanovich took an active part in the public life of the country, showing remarkable human qualities. Confirmation of the merits of B.S. Uvarov to his 100th birthday is the assignment to the B.S. Uvarov Department of Military Anesthesiology and Intensive Care of the S.M. Kirov Military Medical Academy.
Centenary on the protection of the health of military communication workers
Authors: Klimzov A G , Shalkayev E D , Lemeshkin R N
Published: July 2021

The main historical dates of formation and formation of the system of preservation and improvement of health of military personnel from among students (cadets and listeners) and permanent staff (faculty and supporting) of the Military Telecommunications Academy named after the Soviet Union Marshal Budienny S. M. for 100 years are presented. The place and role of the medical service of the Military Telecommunications Academy in the training of military liaison officers are covered. A historical report on the formation of a system of training of military specialists and their health protection is presented. The medical service of the Military Telecommunications Academy, as a structural unit, began operations in 1932. During the ninety-year period of work, the medical service of the Military Telecommunications Academy has gone through a difficult and long path of its formation and development. It was served and employed by various specialists who left significant contributions to the maintenance and preservation of the health of all categories of students and faculty. Today’s days of medical service of the Military Telecommunications Academy are the prevention of the most significant diseases for military personnel, in particular respiratory organs and cardiovascular system. The management of the Academy constantly interacts with the S.M. Kirov Military Medical Academy, 442 Military clinical hospital of the Ministry of Defense of the Russian Federation, as well as in its branches and structural subdivisions. The level of morbidity, hospitalization and labour loss of military personnel of the Military Telecommunications Academy remains quite low. This is facilitated by the good equipment of the functional offices of the medical clinic and the polyclinic of the Academy, where surgical (outpatient), therapeutic, gynaecological and dental care is provided to various contingents of persons entitled by law to receive free medical care.
Possibilities of transient and two-dimensional shear wave elastography in the diagnosis of fibrosis in nonviral chronic diffuse liver diseases in military personnel
Authors: Zhirkov I. I. , Gordienko A. V. , Yakovlev V. V. , Serdyukov D. Y. , Dorohov G. Y. , Vashchenkov V. V. , Brynyuk A. S. , Shichkin M. F.
Published: July 2021

The study examines the possibilities of transient and two-dimensional shear wave elastography in the diagnosis of fibrosis in the most common chronic diffuse liver diseases of non-viral etiology: alcoholic and non-alcoholic fatty liver disease, as well as their combination. It was found that in patients suffering from these diseases, the values of aspartate and alanine aminotransferase, gamma-glutamyl transpeptidase, cholesterol, triglycerides, as well as the oblique vertical size of the right lobe of the liver were significantly (p0,05) higher than in patients of the control group. Moreover, most of these indicators reliably (p0,01) reached the highest values in patients suffering from fatty liver disease of alcohol-metabolic etiology, which confirms a more pronounced damaging effect on the liver with a combination of alcohol and metabolic factors. It has been established that the use of transient and two-dimensional elastography is characterized by high diagnostic significance in determining the stage of fibrosis in chronic diffuse liver diseases of non-viral etiology. The greatest diagnostic significance of elastographic research methods is noted in the third and fourth stages of fibrosis. In the second stage of fibrosis, the quality of diagnostic significance when using transient elastography was higher than when using two-dimensional shear wave. The use of transient and two-dimensional shear wave elastography in most cases avoids liver biopsy in patients suffering from chronic diffuse liver diseases of non-viral etiology. Therefore, in the diagnosis of chronic diffuse liver diseases, the presence and degree of fibrosis is a factor that will largely determine the prognosis, treatment tactics and the likelihood of complications in a particular patient.
Impact of infusion therapy programs on homeostasis indicators in patients suffering from shockogenic trauma from the point of view of statistical reliability
Authors: Stepanov S. S. , Girsh A. O. , Stukanov M. M. , Leonov G. V. , Malyuk A. I. , Eselevich R. V. , Kozlov K. K
Published: July 2021

From the point of view of statistical reliability, the influence of various infusion therapy programs on homeostasis indicators of patients suffering from shockogenic trauma is considered. It has been revealed that when entering the intensive care and intensive care department in patients suffering from severe traumatic shock, against the background of algorithms of anti-shock measures at the pre-emergency and hospital stages there are significant individual intervals of examined homeostasis parameters, which indicates expressed personalized disorders of indicators of reflecting function of organs and systems of patients. The variation in the canonical space of the investigated parameters in patients increased after 12 hours, after admission to the intensive care and resuscitation department. Anti-shock therapy contributed to the fact that the distribution of patients of all three groups in the canonical space after the first 24 hours was dynamically compacted, indicating a decrease in differences between patients of each group during the treatment process. Cluster analysis and multi-dimensional scaling revealed the multilateral dynamics of the relationship between independent variables in various infusion therapy programmes. When patients were admitted to the intensive care and intensive care unit, almost the same orientation of the features of connections between independent variables was noted, however, their polarity was recorded during the treatment process. This shows that the infusion therapy program in patients suffering from severe traumatic shock should be carried out taking into account the dynamics of individual disorders of the investigated homeostasis parameters. It has been statistically proven that different infusion therapy programs have very different effects on homeostasis rates. The use of sterofundin isotonic and 4% modified gelatin in this category of patients has been proven to be the most effective and safe volemic recovery scheme.
Analysis of incidence of tibia stress fractures among the militaries
Authors: Omarov G. J. , Paltushev A. A. , Panov S. A. , Iontsev V. I. , Apchel V. Y.
Published: July 2021

Аbstract. In the process of special training of military servicemen, various elements of the musculoskeletal system of a person are constantly exposed to mechanical loads of various frequencies, intensities and strengths. With such prolonged and shock loads characteristic of military personnel and athletes, permanent minor damage to the bones occurs, which over time can lead to impaired formation of bones and joints, up to the development of the disease. Violation of the motor reactions of the limb ultimately leads to the suppression of the mechanisms of social adaptation, physiological functions and aggravates the course of most diseases, decompensating processes that affect not only the quality of life, but also its duration. A very important point is that labor losses in military personnel during stress fractures can reach 6 months, which negatively affects the service, with a total duration of 12 months of military service. In this regard, questions arise about the advisability of such military servicemen in the army and further spending of budget funds for their maintenance. The stress fractures of long bones are analyzed on the example of fractures of the tibia. It has been established that the greatest number of injuries associated with stress fractures occur during combat training conducted in a special military uniform. A feature of the course of stress fractures is increasing pain in the limb. Among injured with tension fractures, 83,5% of the military did not do the sports before drafting, and physical activity that arose during the service was difficult or not tolerated.
Dynamic medical observation of the flight crew in the Far North is the basis of the primary prevention of adaptation disorders
Authors: Apchel V. Y. , Zagorodnikov G. G. , Zagorodnikov G. N.
Published: July 2021

Dynamic medical monitoring of flight crew during the first year of service in the Far North allows you to organize and carry out activities for the primary prevention of adaptation violations in flight crew. It was established that in pilots with diagnosed diseases of the circulatory system, gastrointestinal tract and various parts of the spine, compared with pilots diagnosed Healthy, there was a statistically significant (p0,01) increase in the average primary morbidity rate by 11,1; 10,8 and 10,7%, respectively, which indicates the tension of adaptive mechanisms in the former in the initial period of adaptation to the conditions of the Far North. Most pilots after assessing such areas of quality of life as physical satisfaction (activity, mobility, the possibility of self-care, full military duties, lack of pain and independence from medications) and psychological satisfaction (emotional background, learning ability, memory, concentration of attention), received integral ratings of 4-5 points. The dynamics of the level of development of cognitive mental processes indicates that in pilots with diagnosed diseases, compared with healthy pilots, there is an increase in the average efficiency indicator of the methods Analogies, Numeric series, Visual memory, Creative thinking; Arithmetic score, Verbal memory and Establishment of patterns, respectively, by 10,5; 10,4; 10,4; 10.5; 10,5; 10,2 and 10,2% (p0,01). Thus, in pilots with diagnosed diseases of the circulatory system, gastrointestinal tract and various parts of the spine, as compared to healthy pilots, adaptive mechanisms are observed in the initial period of adaptation to the conditions of the Far North.