bluuebunny/crossref_metadata_2025 huggingface dataset:
Embolisation of the renal arteries in the treatment of nephrogenic arterial hypertension
Authors: Hubulava G G , Kozlov K L , Mihailov S S , Shishkevich A N , Bessonov E Yu , Bobrovskaya L A , Sedova E V
Published: July 2021

This review article examines the possibilities of surgical treatment of one of the socially significant diseases of modern society - arterial hypertension. The reasons for the development of parenchymal arterial hypertension have been disassembled. The reasons for the development of renovascular hypertension are discussed. Illuminates the pathogenesis of nephrogenic hypertension, statistical data on its prevalence. The issue of embolization of renal arteries in the treatment of nephrogenic arterial hypertension is considered. The forms of nephrogenic arterial hypertension in which the use of embolization is indicated. The etiology and pathogenesis of arterio-venous fistulas of the kidneys are described. Details of the world literature concerning the treatment of arterio-venous fistula and malformations of the kidneys are considered in detail. A review of literature data on materials used in embolisation of renal arteries in patients with arteriovenous fistula and malformations of the kidney is given. The etiology and pathogenesis of arterio-venous malformations of the kidneys are highlighted. The goal of embolization of the renal arteries in the preparation of patients with terminal renal failure and resistant arterial hypertension to kidney transplantation is described. The issue of preoperative preparation of patients before embolization of the renal arteries, the choice of operative access is considered. Methods of embolization of the renal arteries, possible complications and methods of their prevention are described. The data of the world literature concerning application of selective and superselective embolization of renal arteries in patients with parenchymal arterial hypertension are covered. The issue of potential use of renal artery embolization in other forms of nephrogenic arterial hypertension is also highlighted.
Labor practices - a promising area of social responsibility for pharmacy organizations
Authors: Kareva N N
Published: July 2021

The theoretical bases of the social responsibility of business, the search for perspective directions of its development, as well as the historical aspects of the formation of the social responsibility of entrepreneurs abroad and in Russia are considered. The full characterization of external and internal directions of social responsibility is given, its multi- level character, conceptual definitions are shown. Thus, American scientists in their work on management in the United States define social responsibility as the actions of an organization that are undertaken for the benefit of society voluntarily, and not on demand. In modern Russian science, the social responsibility of business is defined as a broad concept that includes the complex responsibility of a business partner, employer, citizen and participant in social relations; as well as social responsibility implies the entrepreneur’s refusal to carry out activities that could harm society, in other words, the business should follow the principle of do no harm, and help. It is noted that in recent years in the Russian Federation the issues of social responsibility of business are considered in relation not only to large, but also to small business. It has been established that the interests of pharmacy workers today are not only in obtaining decent wages, but also in realizing goals such as job satisfaction, respect for the individual, support for education and career, etc. Long-term directions for the development of social responsibility of pharmacy organizations are formulated. A list of socially responsible labor practices is defined, the main ones being: the provision of comfortable and safe jobs; development of labor potential of employees (competence, skills, training, career growth, etc.); building of confidential relations of the employer with employees (truthful informing about the state of affairs in the organization, avoidance of deception and discrimination of employees), etc. Socially responsible labor practices can become the basis of their own social programs of employers, which will not only avoid the turnover of staff, but also attract the best specialists in the market, ensure the growth of the reputation of the organization and improve its image, which in the long run will be a promising advantage in the competition between pharmacy organizations.
At the origins of the native medical aviation accidents study (to the 110th anniversary of the birth of A.G. Shishov)
Authors: Blaginin A A , Afon’kin S V , Annenkov O A
Published: July 2021

The life and scientific path of Shishov Anatoly Grigoryevich - the founder of aviation medical avariology, the first chief of the Department of Aviation Medicine of the Military Medical Academy named after S.M. Kirov (1958-1965). A.G. Shishov is known for his work in the field of the study of causes, investigation and prevention of aviation accidents, professional selection of flight crew, medical and flight expertise, flight training simulators. A.G. Shishov justified the leading role of the «personal factor» in the development of aviation accidents. He introduced the practice of studying the psychophysiological state and individual characteristics of the personality of the pilot and increased the role of the aviation doctor in the investigation of aviation accidents to the status of a mandatory expert. A.G. Shishov developed an algorithm for the medical study of aviation accidents, incidents and erroneous actions of the flight crew, as well as a complex of medical measures for the prevention of accidents.
Tolerance in young people in the tuition in an educational institution
Authors: Uliukin I M , Berezovskii A V , Bolekhan V N , Orlova E S
Published: July 2021

Аbstract. The issues of tolerance in young people in the process of learning in an educational institution are analyzed. At present, representatives of different cultural traditions, principles of life are forced to share one geographical space. This rapprochement, as real experience shows, does not always proceed peacefully and calmly. Interethnic (intercultural) tension, right up to open confrontation, ethnocentrism, xenophobia - all this testifies to serious problems in modern social relations. There is an opinion that in spite of all the relevance and discussion of this topic in broad social science circles there are no unified approaches to understanding the essential characteristics of the phenomenon of tolerance, there is no understanding of who and how tolerant relations are possible, what are the mechanisms for achieving this goal, Some people see it as a kind of a panacea through which only it is possible to save and preserve civilization, while others believe that it serves only to symbolically hide and cure the real schism and indifference that humanity is exhibiting. A theoretical analysis of the essence of the concept of «tolerance» is reduced to the fact that tolerance by origin is a social category (arises and manifests itself in the process of human interaction with society, with man); it fixes a special (non-violent) type of relationship between a person and society. A characteristic feature of tolerance is the stability of manifestations: at the level of consciousness, it manifests itself in the form of an individual’s attitude, and at the level of behavior as a conscious action or deed, as co-creation. Often, researchers formulate such tasks of psychological and pedagogical activity on the formation of ethnic tolerance of students as the formation of a value attitude to one’s own and other ethnocultures; the formation of motivation for intercultural cooperation; fostering a positive attitude towards cultural differences, the development of intercultural sensitivity; development of skills and skills for effective interaction with representatives of different cultures in the spirit of peace, ethnic tolerance and mutual understanding. Therefore, an important condition for joint activities is the creation in groups with a mixed national composition of an atmosphere of inter-ethnic understanding and tolerance, where everyone, regardless of ethnicity, feels comfortable, open to interaction with others, where ethical standards of behavior in interpersonal communication are observed. That is, the cognitive and emotional components of tolerance are most significant when there are contradictions, clashes of values, dissent in conflict situations. Wherein a tolerant behavior is characterized by the ability not to actualize the conflict, which in turn is determined by the level of upbringing and education.
Some health aspects of the Battle of Stalingrad with elements of philosophical comprehension
Authors: Koshelev V P , Kornushko I G , Shpanka A V , Vyazovichenko Yu E
Published: July 2021

Presents extensive historical material unparalleled feat of the Soviet people for a liquidation of consequences of the most ambitious in its bitterness of the battle of Stalingrad, where the cost of enormous effort and enormous human sacrifices our country was able to refract the course of historical events in the Great Patriotic war in their favour. Extremely violent confrontation predetermined the loss of troops, where only in the defensive period of the Stalingrad battle a day killed up to 3,000 people and about the same number of wounded. The severe sanitary and epidemiological situation after the battle, where a huge mass of decaying human bodies remained unburied in a relatively small area of hostilities, and what incredible efforts were made to prevent the impending epidemic of dangerous infectious diseases. The contribution of the outstanding scientist-microbiologist Z. V. Ermoleva and the implementation of her bold decisions in the prevention of cholera epidemic are described. The story is about one of the participants of the battle of Stalingrad on the part of the enemy, but played a huge role in the construction of a moral bridge between the fiercely opposing sides of evil and the liberation of Kurt Roiber - a participant in the battle of Stalingrad, who died in a camp for prisoners of war, but left a number of unforgettable drawings, one of which is the «Stalingrad Madonna» - the fruit of observations and a deep understanding of Russian children and mothers, destitute by military actions, calling in their own way to protect the world over their heads. K. Reiber was able to recognize the inhumanity of war, but that he had to himself to go through this hell. Only by relying on these sensitive triggers of our state of mind can we preserve the memory of the tragedy and the role of Russia’s unparalleled feat, which set an example to the whole world, including the enemy of the power of our indomitable Soviet spirit. And, no matter how hard it was, we should know and often remember these days of the hardest struggle and the great victory.
The birth of military medical education in the Moscow state
Authors: Koshelev V P , Kornushko I G , Shpanka A V , Vyazovichenko Y E
Published: July 2021

The beginning of the formation of military medical education which, first of all, concentrated in Moscow is considered. The role of the pharmacy order and the Russian school of medicine is shown. It is established that the practical traditions in the preparation of the doctor, laid down in the school of medicine were picked up and successfully developed in the hospital school of the Moscow military Imperial hospital. The hospital as the first state medical institution in Russia has actually become the cradle of the national hospital business, medical science and education. The curriculum of the hospital school included theoretical and practical medical disciplines in a larger volume than in the medical faculties of foreign universities. In the past high stands, the role of the famous doctor-Galarza put my whole life on the development of the higher military medical education in Russia - Nicholas bidloo Labertouche. In 1733 the new staff of Medical Office was approved. On the model of the Moscow hospital school (later called the medical-surgical school), established two surgical schools in St. Petersburg at The land and Admiralty hospitals, and one - in Kronstadt. The facts presented in the article convincingly confirm and show the significant role of hospital schools as a centre of formation and development of military medical and General medical education in the XVIII century in Russia. A special role is given to the positive role of «foreign» doctors (Bidloo, Kondoidi), persistently involved in the field of medical support and education of Russia at that time, emphasized the role of progressive public figures in the formation and development of the rudiments of military medical education of the time - B. Godunov, and especially Peter the Great. Attention is drawn to the organizational and methodological support of the educational process - admission to the training of interested representatives of theological seminaries; development of original textbooks based on the most modern theories and views of the medical direction necessarily processed through the prism of the Russian experience of medical care and treatment at the bedside.
A CLINICAL CASE OF COMBINATION OF KONN’S DISEASE AND MULTIPLE NEOPLASIA
Authors: Arapkhanova M M , Starodubtsev Ya V , Aksenov V V , Serdyukov S V , Salikova S P , Grinevich V B
Published: July 2021

The description of the clinical case of combination of Konn’s disease and multiple neoplastic processes, differentialdiagnostic search of syndrome that conbines existing neoplasia in a single nosological form is presented in the article
AUTOAGGRESSIVE BEHAVIOR IN YOUNG PERSONS
Authors: Ulyukin I M , Emel’yanov V N , Bolekhan V N , Orlova E S
Published: July 2021

Modern trends in psychopathology are the increase in the number of patients who need psychiatric or psychological assistance, inadequate staffing of the mental health system, low psychological culture of the population, lack of a system of early detection of predisposition to psychopathology. The review is devoted to one of the unsolved problems - this is a problem of autoaggressive behavior, which manifests itself in self-blame, self-abuse, self-injury, suicide, self-destructive behavior (drunkenness, alcoholism, drug addiction, risky sexual behavior, choice of extreme sports, dangerous occupations, provoking behavior), and it is one of the most relevant in the field of mental health. The risk factors for self-harm, both in the clinical and in the conventionally normal population, are usually considered within two large groups: a) external (environmental or psychosocial factors and traumatic events), b) internal (personal) factors and their interaction. Although most of the self-harm observed in normative mental development in adolescence, adolescence and young age is preclinical and is nonincidental, suicidal intentions can’t be completely ruled out, which requires mandatory testing and clarification of the possible suicide risk in self-destructive behavior within the planned therapy and the selection of relevant targets psychological correction. Since the main contingent requiring registration and assistance is someone who has committed a suicidal attempt, the prevention of a repeated autoaggressive action is the main task of the work of specialists providing psychological and medical and social assistance in the post-suicide period
TRANSPAPILLARY ENDOSCOPIC SURGERY: COMPLICATIONS AND PREVENTION OF THEIR DEVELOPMENT
Authors: Romashchenko P N , Filin A A , Maistrenko N A , Fekliunin A A , Zherebtsov E S
Published: July 2021

Improvement of endoscopic techniques and tools, minimal invasiveness of transpapillary endoscopic surgery (TES), accumulated experience, as well as the introduction of preventive measures, do not always avoid the development of life-threatening complications (6.8 - 10,2% of patients) and deaths (1,7 - 3%). The purpose of the study is to assess the practical significance of the proposed predictors of TES complications in the treatment of patients with impaired patency of the ductal systems of the liver and pancreas, to propose program measures for the prevention of complications. The results of TES in 3305 patients performed in the planned and emergency order with various diseases of the hepatopancreatobiliary region are analyzed. Based on multivariate analysis, statistically significant (p 0.05) predictors of major life-threatening complications of TES were distinguished: 1) post-operative pancreatitis (female (78.2%), difficult cannulation (54.6%), multiple cannulation, fast / tight contrasting pancreatic duct (49.4%)); 2) bleeding (current mode (52.1%), presence of cholangitis (43.5%), coagulopathy in the presence of jaundice (65.2%)); 3) duodenum perforation (elderly and senile age (68.2%), difficult cannulation (66.7%)); 4) acute cholangitis (inadequate drainage of the bile ducts (83.3%), unsuccessful attempt to drain the bile ducts (48.6%)). We are supplemented prophylactic measures for postoperative complications in case of TES. A personalized record of the main predictors of complications of the feasibility study and the use of a program of preventive measures will allow an adequate choice of tactical approaches and technical options for operations, which will lead to improved treatment outcomes, minimizing the frequency of complications and mortality.
URGENT OPERATIONS IN PATIONS WITH DISEASES OF THYROID GLAND COMPLICATED BY COMPRESSION OF NECK AND MEDIASTINUM
Authors: Gostimskii A V , Romanchishen A F , Selikhanov B A , Lisovskii O V
Published: July 2021

Reports of immediately and urgent interventions on the thyroid gland are rare. The aim of the study was to develop and put into practice the optimal tactics of treating patients with nodular tumors of the thyroid gland, which caused compression of the organs of the neck and mediastinum. From 1974 to 2015, 97 patients with thyroid disease were operated in the Endocrine Surgery Center, they was 0.57% of 29325 patients. All patients had symptoms of compression syndrome. All patients were divided into 2 groups. I group consist of 52 (31.1%) patient who underwent immediately surgical interventions. The second group included 115 (68.9%) patients operated for urgent indications. The mean age of patients operated for immediately reasons was 73.0 ± 1.39 year.The mean age of patients operated for urgent indications was 63.8 ± 1.51 year. Among the reasons that caused the compression syndrome, the differentiated cancer of the thyroid gland was observed in 79 (47.3%) cases. Benign thyroid diseases caused urgent surgical interventions in 88 (52.7%) patients. In our work, we first used the definition of the degree of tracheal constriction with spirography in 135 (80.84%) patients to identify the timing of surgery. In the course of emergency surgical interventions, radical operations were performed on 8 (22.9%) patients with differentiatedcancer of the thyroid gland, in cases of urgent interventions, this figure is 2 times more - 23 (52.3%) patients. The performance of urgent operations increases the possibility of radical surgical interventions, reducing the frequency of postoperative complications.
THE CHARACTERISTICS OF PREVALENCE AND ANALYSIS OF RESULTS OF TREATMENT OF DIABETIC FOOT SYNDROME
Authors: Demicheva T P
Published: July 2021

Diabetic foot syndrome (SDS) is one of the most severe complications of diabetes mellitus (DM), and the treatment of such patients is one of the difficult tasks. Purpose: to present the epidemiological characteristics of SDS on the basis of the state register of SDS of the Perm region and to analyze the results of treatment of this category of patients in different departments of surgical profile. Evaluation of results of treatment was given on the basis of expert analysis of 150 case histories of the patients Patients were performed General clinical examination, microbiological examination of the wound content, rheovasography, angiography, duplex scanning, x-ray examination of the feet, the survey for the assessment of the risk of developing VTS. According to the register, SDS was registered in patients older than 18 years with type 2 diabetes in 4.4 % of cases. The prevalence of SDS and amputations correlated with the duration of type 2 diabetes. The average age of SDS development was 64.3±0.5 years. Inpatients belonged to the older age group, had long-term disease poorly compensated diabetes in combination with associated diseases. The average duration of the purulent-necrotic process was 1 month. Patients had an average risk of SDS according to the survey. In the specialized Department of vascular surgery, the effectiveness of treatment was higher, due to the level of diagnosis and the use of innovative surgical technologies. All of the above is a significant argument in favor of the development of specialized care for patients with diabetic foot syndrome.
3D- SIMULATION AS THE METHOD OF TOPICAL DIAGNOSTICS IN THE SURGICAL TREATMENT OF GIPERPARATIREOZA
Authors: Makarov I V , Zhirov V V , Kolsanov A V , Galkin R A , Sidorov A Y
Published: July 2021

Urgency of theme. Morbidity by primary giperparatireozom (PGPT) varies from 0,4 to 18,8 the cases for 10000 the populations. Defeat the parathyroid glands in patients with second (VGPT) and tertiary (TGPT) giperparatireozom, who are found on program hemodialysis reaches 32-34%. The only method of treatment is surgical. The effectiveness of operational interference in many respects depends on verification and visualization of all the pathologically changed parathyroid glands. Purpose. To improve topical diagnostics of parathyroid adenomas by constructing the personified preoperation 3d-model of the anatomical formations of neck on basis MRT. Materials and methods. Preoperation 3d-simulation is executed 10 to the patients: 3 by patient with PGPT, 7 patient with TGPT. For obtaining the personified 3d-model were used results MRT and special software (priority information №2018122324, also, 2018122326 from 18.06.2018). In the regime of preoperation planning were built the three-dimensional models of neck with the designation of trachea, the thyroid gland, the parathyroid glands, gullet, collar bones. Obtained results. With the use of preoperation 3d-simulation it was possible to avoid diagnostic eksploratsii of neck in search of not less 4th parathyroid glands, was reduced the time of the fulfillment of operational interference on the average on 30±15 minutes, was possible to avoid the postoperative complications, connected with the damage of recurrent guttural nerves. Conclusion. The method proposed is the reliable method of pre-operation topical diagnostics of pathologically changed parathyroid glands. With the use of 3d-simulation the operation time decreases, is reduced the need for traumatic and expensive on the time eksploratsii of neck, necessary for the search for changed parathyroid glands, and, correspondingly, the probability of the development of postoperative complications. This method can serve as the objective criterion of visualization parathyroid glands and also as the criterion of effectiveness of the carried out treatment
REHABILITATION OF PATIENTS AFTER OPERATIONS ON THE THYROID
Authors: Pamputis S N , Aleksandrov Yu K , Dyakiv A D , Belyakov I E
Published: July 2021

Scientists and specialists, who works in the field of treatment thyroid gland diseases, identify and eliminate the effects of surgical interventions with nodular, multinodular and recurrent goiter with symptoms of compression of the organs of the neck and upper mediastinum. In total, the study included 119 patients who underwent extirpation of the thyroid gland (43), resection of the thyroid gland (33) and hemithyroidectomy (43). Comparisons were made on the basis of the volume of the preoperative examination, the immediate surgical intervention and the features of the intraoperative technique. It was established that the severity of local pain, postoperative complications such as neck edema during hematoma and gray formation reliably depended on the size of the skin incision, dissection of the short neck muscles, mobilization of the nodding muscles and removal of the tissue from the lymph nodes. 6 months after the surgical treatment, the patients had no complaints. If hypocalcemia occurs (in 14 cases), patients undergo a comprehensive treatment according to the original scheme. As a result of the treatment in all cases, the action of hypocalcemia was stopped. The study shows that the effectiveness of surgical treatment, the postoperative period, complications, cosmetic results and quality of life, as well as rehabilitation studies aimed at reducing the effectiveness of preoperative examination, increasing the amount of operational benefits and late statement of complications.
PROBABILITY OF CANCER DETECTION DURING REPEATED OPERATIONS IN PATIENTS WITH BENIGN THYROID DISEASES
Authors: Romanchishen A F , Gostimsky A V , Akinchev A L , Karpatsky I V
Published: July 2021

Introduction. Suspected malignant growth in patients with recurrent goiter is one of the main causes of repeated operations. Focuses of carcinoma can be detected in patients operated on for multinodular goiter with compression of the organs of the neck, recurrent diffuse toxic goiter. Objective of investigation is to assess the risk of a malignant lesion of the thyroid remnant in patients with recurrent goiter, to justify the surgical tactics in this group of patients. Material and methods. In the St. Petersburg Center of Endocrine Surgery and Oncology 28138 patients with various thyroid diseases were operated on for the period from 1973 till 2016. Results. In a retrospective analysis of the group consisting of 1106 patients with recurrent goiter, a new thyroid disease was detected in 156 (14.1%) cases. Thyroid cancer in thyroid remnant was detected in 57 (36.5%) cases or 5.2% of all the patients with recurrent goiter. The work describes the risk of malignant lesion of the thyroid remnant in patients with recurrent goiter and surgical tactics in this group of patients. Conclusion. Cancer of the thyroid gland, as a new disease of the thyroid remnant, in patients previously operated on for benign thyroid pathology, is found in 5.2% of observations. The possibilities of fine-needle aspiration biopsy in this group are reduced. Active surgical tactics in cases of multinodular transformation of the thyroid remnant is justified. The operation of choice is reresection up to thyroidectomy. Careful intraoperative study of removed tissue and close cooperation with the morphological service helps to reduce the number of diagnostic and tactical errors in patients with both recurrent and ordinary multi-node goiter.
The use of self-adhesive composite in the treatment and prevention of secondary caries in the II class according to Black
Authors: Borisova E. G. , Nikitenko V. V. , Vorobiova Yu. B.
Published: July 2021

The quality of filling of carious cavities of class II according to Black, using adhesive preparation in the classical way and using a self-adhesive composite on a restored surface is analyzed in this article. On a human tooth extracted for medical reasons, a carious cavity of class II according to Black was prepared. Next, conditioning of the hard tissues of the tooth was performed. It was revealed that the conditioner is poorly washed out of the tooth cavity and there is a possibility that phosphoric acid will remain between the matrix system and tooth tissues, it can lead to complications. Then, an adhesive system was applied to the prepared cavity with a microapplicator, which was rubbed strictly according to the instructions, polymerized. On another tooth removed for medical reasons, the filling of the carious cavity of class II according to Black was performed by the self-adhesive fluid composite Vertise Flow according to the technique developed by us. Instead of adhesive and flowable material, the composite was applied on the prepared enamel of the contact surface. In the study of sections revealed that the restoration of the contact surface is made in accordance with the anatomical features of the tooth, with a high-quality edge fit. This demonstrate the effectiveness of filling without adhesive preparation of the contact point. The use of Vertise Flow self-adhesive composite, during restoration of class II according to Black, allows to improve the quality of treatment. Micromechanical retention, as a result of which interpenetration occurs between the polymerized particles of the Vertise Flow composite monomer and the dentin collagen fibers, allows the formation of a diffusion zone and close contact between the material and the enamel surface. This fact allows to eliminate the defect of filling by the absence of an «adhesive side», which occurs under the classical adhesive protocol, thereby making prevention of secondary caries of class II according to Black.
Results обследования of the women, suffering from disease of the thyroid gland
Authors: Garayeva K. G.
Published: July 2021

The results of the examination of pregnant women suffering from thyroid gland pathology are presented. It was found that 15 (37%) pregnant women out of 41 examined had hyperthyroidism and 26 (63%) are hypothyroids. Both pathologies are recommended for iodine deficiency in 200 mcg per day, in addition to special nutritional supplements. The pregnant women with hyperthyroidism, during the first 3 months of pregnancy, are being prescribed 2 tablets 3–4 times daily (300–400 mg) propyltiocracil and 3 tablets per day, in addition to potassium iodine in pregnant women, 30 minutes before the meal, 30–40 mg thymazole has been prescribed. It has been established that the course of pregnancy is proportional to the density of thyroid hormones. The thickness of thyroid hormones in the blood is regulated as a result of the treatment. It has been established that the alteration in the density of hormones in the pathological direction is a risk factor for the flawed development of the fetus in the prenatal period. Based on the findings, we conclude that in pregnant women with pathology of thyroid gland, pregnancy should be determined at the end of first, second and third trimester, and blood pressure should be adjusted to include thyroid hormones, including thyroid-stimulating hormone, triiodothyronine and thyroxine. If an imbalance of hormones is detected, drug therapy aimed at regulating the level of thyroid hormones in the blood is recommended.
Surgical treatment of Forestier disease
Authors: Orlov V. P. , Idrichan S. M. , Alekseyev E. D. , Mirzametov S. D.
Published: July 2021

Historical information, epidemiology, risk factors, diagnosis and known methods of treating diffuse idiopathic skeletal hyperostosis – Forestier disease – a rare idiopathic non-inflammatory disease of the musculoskeletal system characterized by ossification of ligaments and tendons, gradually leading to ankylosis, are presented. The differential diagnostic criteria for this disease are listed. The clinical picture of vertebral and extravertebral localization of foci of hyperostosis is described. A clinical case of severe recurrent idiopathic hyperostosis of the cervical spine, manifested by dysphonia, dysphagia and pain, is considered. The peculiarity of this case is gross hyperostosis, which is a recurrence of Forestier disease in the cervical spine 12 years after surgical treatment. The indications and the required volume of the operation, as well as the difficulties of re-surgical treatment of Forestier disease with localization of hyperostosis in the cervical spine, are listed. In general, repeated surgical treatment of Forestier disease is associated with a pronounced scar-adhesive process, which increases the duration of the operation and the amount of blood loss. In case of damage to the cervical spine with severe compression of the pharynx, esophagus and respiratory tract, it is enough to perform a decompressive intervention. A stabilizing benefit is not required, due to the lack of signs of instability of the operated vertebral-motor segment both intraoperatively and in the postoperative period. At the same time, surgical treatment with this nosology is not radical and does not cure patients even at the level of surgical intervention. However, the operation is indicated for severe compression of the neck organs and neurovascular structures.
Medical and psychological rehabilitation of servicemen serving in the Arctic zone of Russia
Authors: Dolgikh S V , Ponomarenko G N , Bobrov L L , Ishchuk V N , Merzlikin A V
Published: July 2021

The analysis and results of the generalization of domestic scientific research on the issues of service activities of military personnel and civilians in the Arctic are given. The problems of the organization of the protection of the health of servicemen serving in the Arctic region are shown. It has been established that military personnel performing combat training tasks in the Arctic zone of Russia mainly (more than 95% of cases) have the following types of psychophysical and neurotic disadaptosis - somatoform dysfunction of the autonomic nervous system, overwork, restrictions on activity caused by a decrease or disability. The role of medical and psychological rehabilitation as one of the effective methods for the prevention and treatment of maladaptive disorders in the military has been shown. Methodical approaches to the organization of medical and psychological rehabilitation of servicemen performing training and combat tasks in the Arctic zone of Russia, in particular, recommendations on the use of corrective methods in accordance with the clinical characteristics of syndromes are proposed.
Factors of suicidal behavior in military personnel with borderline mental disorders
Authors: Seregin D. A. , Dnov K. V. , Markin K. V. , Yatmanov A. N.
Published: July 2021

The factors of suicidal behavior in military personnel with borderline mental disorders are considered. It has been established that in military personnel suffering from borderline mental disorders and suicidal behavior, disorders of adaptive reactions are more common in the structure of mental diseases than personality disorders and other mental disorders. When conducting a discriminant analysis using the «forward step by step» method, a model for predicting suicidal behavior of patients with borderline mental pathology was obtained: Lambda Wilks: 0,64125 approx. F (18,438)=6,0538; p0,0001, predictive ability 80.9%. Factors of suicidal behavior of patients suffering from borderline mental pathology are: a combination of social (level of education, the influence of the media); biological (power index, weight-rate index, standard deviation of R–R intervals of heart rate variability); and psychological characteristics (a history of suicidal attempts, computer addiction, consultations with a psychiatrist or psychologist in childhood and adolescence, social introversion). The developed mathematical model makes it possible to increase the level of effectiveness of early detection of suicidal individuals among military personnel.
Chronic diffuse liver disease of non-viral etiology in the military
Authors: Zhirkov I. I. , Gordienko A. V. , Gulyaev N. I. , Serdyukov D. Yu. , Stepanova A. A.
Published: July 2021

The prevalence and structure of chronic diffuse liver diseases of non-viral etiology in 282 military men of the Western military district of different types of troops was studied. These diseases were detected in 164 (58,1%), of which non- alcoholic fatty liver disease was detected in 94 (33,3%) people, alcoholic liver disease – in 22 (7,8%), fatty liver disease of alcoholic metabolic etiology – in 48 (17%) of the examined. There were no cases of cholestatic, drug and autoimmune liver damage in the examined contingent. The proportion of favorable variant of chronic diffuse liver disease in the form of steatosis in persons suffering from non-alcoholic fatty liver disease was 80,9%, with alcohol-metabolic lesions – 75%, in the group of alcoholic liver disease – 100% of cases. The ratio of nosological forms in the structure of incidence of chronic diffuse liver diseases in the examined contingent was as follows: non-alcoholic steatosis – 46,3%, non-alcoholic steatohepatitis – 11%, alcoholic steatosis – 13,4%, alcoholic-metabolic steatosis – 22%, alcoholic-metabolic steatohepatitis – 7,3%. It was revealed that after 30 years the number of persons suffering from chronic diffuse liver diseases increased significantly (p0,05) from 46,4 to 61,8%, mainly due to the increase in the incidence of fatty liver disease of alcoholic and metabolic etiology from 4,9 to 22,1%. The modulus of liver elasticity characterizing the degree of fibrosis in the group of non-alcoholic fatty liver disease and fatty liver disease of alcoholic metabolic etiology (5,8 kPa [5,2; 6,4] and 6,3 kPa [5,2; 7,4], respectively) was significantly (p0,001) higher than in the control group (4,6 kPa [4,3; 4,9]). The controlled parameter of ultrasound attenuation reflecting the degree of steatosis in patients with non-alcoholic fatty liver disease and fatty liver disease of alcoholic metabolic etiology was higher than normal parameters (280 dB/m [268; 291], 303 dB/m [284; 322] and 233 dB/m, respectively) and significantly (p0,001) differed from the values of the control group (223 dB/m [214; 233]). The degree of steatosis in the group of fatty liver disease of alcoholic metabolic etiology was significantly (p0,05) higher than in the group of non-alcoholic fatty liver disease.
Influence of the conditions of military-professional activity on reproductive health of military females which are training in tank regiment
Authors: Shmidt А. А. , Ganapolskiy V. P. , Sadovaia N. D. , Timoshkova Yu. L.
Published: July 2021

The influence of the conditions of military professional activity on the reproductive health of female military personnel studying on the basis of a tank regiment is analyzed. It is known that the operating conditions of tankers are characterized by specific features that complicate and impede work, adversely affect combat efficiency and health. In August 2019, in the Russian Federation, for the first time in the history of the Tank Biathlon military competition, which took place as part of international army games, a crew consisting entirely of female military personnel took part. In this regard, new tasks have arisen regarding the organization of military professional activity, considering the physiological, anatomical, psychophysiological characteristics of the female body, considering that the physiological characteristics of the female body affect professional health, and military labor factors, in turn, manifest themselves as an adverse effect on the state of somatic and reproductive health of female military personnel. A gynecological examination of 26 female military personnel undergoing retraining in a training tank regiment (military unit 30616) in the village of Pakino, Vladimir Region, was performed to identify the incidence or other health problems resulting from adaptation to specific conditions of service. It included: a survey (collection of complaints, clarification of gynecological and obstetric anamnesis), examination of the mammary glands, gynecological examination, taking smears for vaginal biocenosis and oncocytology from the cervix with subsequent interpretation of the results, ultrasound examination of the pelvic organs. It was revealed that inflammatory diseases of the lower genital tract (65%) and, to a lesser extent, cervical ectopy (27%) and menstrual irregularities (23%) predominated from the pathology of the genitourinary system. In order to preserve the professional, reproductive health and specific functions of the female body, it is necessary to take measures to introduce targeted hygienic education of female military personnel, early diagnosis and regular medical examination, as well as introduce an individual hygiene kit into everyday use that is aimed at timely prevention, effective self-diagnosis and treatment of inflammatory pathology of the lower female genital tract, as well as to prevent unwanted No pregnancy and early pregnancy diagnosis.
Peculiarities of the mental health of servicemen serving in submerged command posts.
Authors: Abritalin E Yu , Zhovnerchuk I Yu , Zhovnerchuk E V
Published: July 2021

The features of the mental health of 150 servicemen (an experimental group), who perform military service in submerged command posts, are analyzed in comparison with 60 servicemen whose professional activities are outside the influence of the conditions of these points (control group). It has been established that the mental health indicators of the military personnel of the experimental group differ for the worse in comparison with the same indicators in the control group. With an increase in the duration of service in the buried points, the severity of mental disorders increases, and the level of social adaptation decreases, which necessitates an expansion of the scope of psycho-preventive measures. Within the framework of psycho-prevention, it is advisable to conduct psychocorrectional measures with the use of methods of mental self-regulation, allowing to improve the neuro-psychological adaptation of military personnel.
Terms of hospitalization and morphological forms of appendicitis: experience of a versatile hospital of an emergency medical service
Authors: Gavshchuk M. V. , Barsukova I. M. , Gostimsky A. V. , Demko A. E. , Karpatsky I. V. , Vashetko R. V.
Published: July 2021

It was performed a comparative analysis of the hospitalization and operation terms with morphological changes of appendices, removed from 316 patients with acute appendicitis, treated at the St.-Petersburg Research Institute of Emergency Care named after I.I. Janelidze for the year 2017. The patients were from 19 to 91 years old, with an average age of 36,2±13,63 years. Among the patients, there were 188 (59,5%) men and 128 (40,5%) women. The period from the onset of the disease to the moment of hospitalization ranged from 1,5 to 264 hours (11 days), the median was 14 hours, mode – 24 hours, 75% percentile – 24 hours, 25% percentile – 7 hours. Histological examination of removed appendices revealed catarrhal appendicitis in 23 (7,3%) cases, phlegmonous in 232 (73,4%), gangrenous in 48 (15,2%) cases, chronic appendicitis in 1 (0,3%) case. In 3 (0,9%) cases dense appendicular infiltrates were diagnosed and treated conservatively. Tumors were detected in 6 (1,9%) cases. The time required for hospitalization of patients with catarrhal appendicitis was from 2,75 to 120 hours from the onset of the disease, the median – 14 hours, mode – 6 hours, 75% percentile – 24 hours, 25% percentile – 6 hours. The duration of the examination and observation from the moment of appellation for medical treatment to the operation was from 2,68 to 35 hours, the median – 7 hours, mode – no, 75% percentile – 10,9 hours, 25% percentile – 4,5 hours. The period from the moment of onset of the disease to operation was from 7,5 to 120 hours, the median – 24 hours, mode – 36 hours, 75% percentile – 36 hours, 25% percentile – 16,8 hours. Observation in doubtful cases compensated early hospitalization and reduced number of operations for catarrhal appendicitis to 7,3%. At the same time, there was only 1 (0,3%) case of the removal of appendix with signs of only chronic appendicitis.
Community-acquired pneumonia in elderly patients: the effectiveness of antimicrobial therapy regimens.
Authors: Kulagina I Ts , Likhodii V I , Zaitsev A A
Published: July 2021

The clinical efficacy of using «protected» aminopenicillins (amoxicillin/clavulanate, amoxicillin/sulbactam) and the 3rd generation cephalosporins in the treatment of mild community-acquired pneumonia in patients older than 60 years in hospital has been evaluated. Analyzed 71 case histories. The assessment was carried out on the basis of a comprehensive analysis of clinical, laboratory and radiological data. A comparative analysis of the clinical efficacy and safety of the antibiotic regimens under study demonstrated the obvious advantage of using «protected» aminopenicillins over the existing practice of treating non-severe community-acquired pneumonia in patients of older age groups.
The effect of recombinant flagellin on the hematopoietic system in rats with acute radiation damage
Authors: Sapozhnikov R. Yu. , Khalimov Yu. Sh. , Legeza V. I. , Litvinenko R. I. , Drachev I. S. , Kraev S. Yu. , Simbirtsev A. S.
Published: July 2021

In an experiment on irradiated rats, the effect of prophylactic and therapeutic administration of recombinant flagellin on the course and outcomes of acute radiation damage, as well as peripheral blood parameters, was studied in dynamics. It has been established that the anti-radiation activity of recombinant flagellin is most effective when prophylactically administered 15-30 minutes before irradiation. Thus, when rats were irradiated at a dose of 6 Gy, the survival rate of animals in the control group by the 30th day was 50±14%, and the average life expectancy was 23±3 days. In the case of prophylactic administration of recombinant flagellin at a dose of 100 μg/kg, the survival of irradiated rats increased by 33%, and the average life expectancy by 5 days was 83±11 and 28±2 days, respectively. The introduction of recombinant flagellin in dosages of 1 and 10 μg/kg was not very effective. With the introduction of recombinant flagellin after irradiation, the radioprotective effect of the drug could not be detected. To elucidate the mechanisms of action of recombinant flagellin, its effect on the peripheral blood indices of irradiated animals was studied. In animals of the control group irradiated at a dose of 6 Gy, pronounced leukopenia was observed in the peripheral blood. By 3 days after irradiation, a decrease in the level of leukocytes to 5,1×109/L was noted. As the hematological syndrome of acute radiation damage developed, leukopenia progressed and by 9 days the leukocyte level was 3,2×109/L. On the 14th day, a gradual recovery of the leukocyte pool was noted, in which an increase of almost 2 times was noted compared with 9 days, which amounted to 7×109/L. The recovery of leukocyte levels to reference values was recorded by 25 days, when their level was 31×109/L. All this suggests that the introduction of recombinant flagellin before irradiation at a dose of 100 μg / kg has a protective effect on hematopoietic and bone marrow cells of irradiated rats at a dose of 6 Gy. The results confirm the literature on the prospects of further research aimed at the development of flagellin- containing chemical protection against radiation damage.
Pecularities of medical rehabilitation in a multidisciplinary hospital.
Authors: Khmil A Ya , Shchegolkov A M , Belov D F , Molchanov B A
Published: July 2021

The experience of the Medical and Rehabilitation Clinical Center of the Ministry of Defense of the Russian Federation is highlighted. This multi-disciplinary rehabilitation hospital, due to its staffing and organizational structure, equipment and staffing with highly qualified specialists, has the opportunity to conduct comprehensive medical rehabilitation for patients of all rehabilitation profiles. It effectively works multidisciplinary teams, using all modern methods of medical rehabilitation. Evidence is presented of the high performance of medical rehabilitation measures, thus ensuring a substantial replenishment of the rehabilitation potential of the military medical service. The necessity of further improving the organization of medical rehabilitation of military personnel using the capabilities of a modern multidisciplinary rehabilitation center in the system of medical care for the wounded and sick has been shown.