Pulmonory embolism takes the third place in cardiovascular mortality structure. Separate clinical symptoms don't have adequate sensibility and specificity for pulmonary embolism verification. For pulmonary embolism diagnosis are usually used clinical probability scales. Clinical markers, pulmonic ventricle dysfunction markers, and myocardial injury markers determine risk stratification. Methods for diagnosis and treatment of pulmonary embolism are based on risk levels. In case of suspected pulmonary embolism the treatment should be prescribed immediately without waiting for diagnosis approval. Pulmonary embolism. accompanied with shock and hypotension is. an absolute thrombolytic therapy indication. According to data, provided by authors, efficacy and safety of prourokinase appeared to be as effective and safe as alteplase according to clinical and instrumental criteria. Alteplase effectiveness is higher than prourokinase in case of short anamnesis (<3 days), while in case of long anamnesis (>3 days) proukinase has the advantage of alteplase., To prevent repeated venous thromboembolism should be prescribed indirect anticoagulant (Vitamin K antaonist) or factor Xa inhibitor oral inticoagulant rivaroxaban.
Forum of military physicians of Asia Pacific region. Authors proviae a report about the 3rd Military medical Asia Pacific congress, which was held in August 2016 in Saint Petersburg under the authority of the International military medical committee. Within the frame of the congress was held regional workshop, in the course of which was heard a report of the Thailand representative, requests of observer states for the entry. The country, which will hold the 4th Military medical Asia Pacific congress, is Iran. On the last day of the congress delegates visited the finals of the Military-medical race of the military physicians profession skill competition within <<The international army games-2016>.
One of the priorities of aviation medicine is meaicai sajety ojjugnts. - ne arricie presents tne resuits oj an anaiysis oj current trenas ana the main lines of activity of the medical service for ensuring the safety of flights. The problematic issues of medical control over the health of aviation specialists have been identified and ways of their solution have been proposed.
The article presents a brief description of the sanatorium organizations CCM <<Crimean>> the Defence. Analysed the climatic characteristics of the region, as well as climatotherapeutic, I and other factors used in sanatorium treatment of diseases of the respiratory and circulatory. structure receiving spa treatment, patients' opinions about its effectiveness.
life indicators of patients (n=365) with chronic biliary pancreatitis before the operation, 6 months and up to 10 years after surgical intervention were studied. It was found that the decrease in the quality of life of patients before surgey is mainly due to pain syndrome. After 6 months after the operation, the work capacity and physica activity are gradually restored against the background of a reduction in the pain syndrome. In the late period, the greatest importance is acquired dyspeptic disorders and reduced physical performance. The use of minimally invasive technologies lea to a faster recovery of the quality of ljfe indicators of patients in the postoperative and remote periods, the use of minimally invasive techniques and the dissociation of the common biliary and pancreatic ducts do not have signficant dgeferences and are close to the norm. The worst quality of ljfe was observed in patients who underwent the imposition of choledochusduodenoanastomosis. Qualiy of.
The scheme of the mechanism of degeneration, which allows you to understand the underlying pathogenesis and in the future can be used to assign adequate treatment: antiviral, suspension of cholesterol deposition in retinal layers, the use of drugs against chronic neovascularization, etc. The questions of the military- medical examination for determining of fitness for military service.personnel with retinal disorders caused by age-related degeneration are discussed. It sets out the pathogenesis, risk factors for age-related macular degeneration.
Possibilities of inocardiography for defining systolic left ventricular function when screening of military personnel. Possibilities of definition of myocardial contractile function with the help of the detection method offremitus of vertical lift component, caused by in-space heart movement in patient siting on a dynamometric platform, were researched in 230 patients. As a control method for defining the heart pump function was used the echocardiographic modified biplane Simpson method. It is defined that an appropriate method allows distributing with high certainty patients to groups with normal, moderate impaired and severe impaired myocardial contractility.
Selection of inhalation anaesthetic when low-flow anaesthesia with automated control. A comparative evaluation of low-flow (0,5 l/min) and inhalation anaesthesia with sevoflurane and desfluranom with automated control of the concentration of inhaled anaesthetic on the exhale (Et-control), with the use of advanced monitoring in 76 patients operated on for the pathology of the spine and spinal cord is given. It was found that when using continuous measuring the achievement of the target concentration of the anaesthetic sevoflurane is faster in the group. Total consumption of desflurane was two times higher. Hemodynamic, SPI index were stable at all stages of the operation in both groups.
Peculiarities of training of military medical staff during the Great Patriotic War. Extreme conditions of the World War II required as soon as possible rebuilding the work of institutions for higher medical education concerning training of military medical personnel. During the war significantly changed the organization of educational process in the S.M.Kirov Military Medical Academy, the military-medical faculties and civilian medical institutions. During the war from military medical academies and military medical faculties annually graduated up to 1450 military and naval doctors, civil universities of the country prepared and sent to the front more than 65 thousand doctors. It called up from reserve 80 thousand doctors. Basically staffing problems have been resolved.
Actual issues of an improvement of the medical aid delivery system in case of acute radiopathology in the Armed Forces of the Russian Federation. The article provides information on characteristics of the stage system of medical aid delivery in case of acute radiologic traumas. The authors formulated main directions of improvement of the system under modern conditions. It is shown that as a basis of its improvement may be considered the complex of measures, including formation of standardized clinical recommendations (treatment protocols) on medical care delivery to the wounded at different stages of medical evacuation, expanding of possibilities of special medical aid delivery to patients with acute radiopathology, including formation of mobile reserves for deployment of specialized units under conditions of mass admission of patients with severe forms of radiopathology; renewal of the training system for medical specialists working in the field of acute radiopathology; implementation of information technologies; improvement of interdepartmental interaction on the problems of medical consequences after radiologic emergency situations in peacetime.
Role of military medicine in delivering of health care to ministry of internal affairs staff. The article describes the creation of the Medical Service Ministry of Internal Affairs of the Russian system. Throughout its history, medical-mechanical maintenance of employees of law enforcement bodies, such as in pre-revolutionary period, and in the early years of the Soviet regime was closely linked with military medicine of the Russian Empire and the Red Army. Many police officers, and later the police received medical care in military hospitals. Start the NKVD- MVD departmental health laid in 1921 with the creation of oadmissionso to provide medical care to police officers. As part of the system of state-sensible care, the medical service of the Russian Interior Ministry system and now introduces non-assessable contribution to its development.
Physiological and hygienic requirements imposed on water supply for troops in the Arctic zone. The deployment of military garrisons in the Arctic zone requires solutions of health and working capacity maintenance among the military personnel. One of them is to provide a physiologically adequate and safe water supply. Direct use of water for drinking purposes, obtained by the melting of snow, does not meet the physiological needs of the body as a result of the almost complete lack of mineral salts in it. It determines the urgency of the problem of melt water conditioning. The article contains a review of published data on the historical experience of drinking water quality and its correction on ships of various countries, as well as the ships of the Navy of the USSR. Modern data on salinity and how to use for drinking desalinated seawater on Navy ships, melt water and soft water from natural land water sources. The creation in the garrisons of the Arctic stations zone potable water on the basis of scientific data on the methods of its conditioning (mineralization and disinfection).
Correction of functional state of divers during training camps. The effect of a course of inhaled xenon-oxygen gas mixtures and audiovisual stimulation on the performance of the functional state of divers specialists in the process of intensive training camps is researched. It is shown that the combined use of them has a generally positive effect on the level of the functional state-diving professionals, increasing their individual resistance to adverse factors the complex military-professional environment. The results allow us to consider the combined use of these techniques as a promising means of surgical correction of the functional state of persons whose activities take place in conditions of considerable physical and psycho-emotional stress.
Comparative evaluation of effectivennes and safety of the local hemostatic agents in the experiment. On the model side damage the femoral artery of pigs we performed a comperative test of modern local hemostatic agents (LHA): bandages on the basis of chitosan <<Tseloks Goz >> (TG), eGemofleks Combat> (GC), <GemoBandazh)> (GB) bandages on kaolin-based <<Combat- Goz>> (CG), and the usual bandage 10 cm x 3 m (control group). 25 animals were divided equally into 5 groups. After 45 seconds of bleeding from 6-mm side wound of femoral artery was used LHA with a three-minute external compression and wound edges approximation. In the case of the continuation-bleeding wounds performed re-tamponade with the second package of the LHA. Hemostasis after applying the first packet never recorded in the CG group, occurred in I out of 5 animals in the groups TG and GC, 2 of 5 animals in the group GB and the control group (p>0,05). Application of two packages LHA in the TG group, GB and the control group was effective in 3 of 5 animals and in groups CG and GC - in 2 of 5 animals (p>0,05). Mortality did not differ significantly between the groups. Thus, the conventional bandage wound with ordinary tamponade in this model is not less effective than current LHA.
In anesthetics practice exist different scales and indexes, _through which the evaluation functional condition of the patient. The disadvantage of these scales and tests are subjective evaluation as a condition of the patient, who is able to re-evaluate their functionality and anaesthesiologist, co-tory may underestimate the presence of comorbidities and patient complications in the postoperative period. The method of improvement of objective assessment of the patient's functional reserves, of a cardiorespiratory exercise testing is given. The methodology of testing in 18 patients, who were later performed surgery on the abdominal organs. The definition-of anaerobic threshold was conducted using V-slope method. In all cases was reached and was 11,1 (10,1; 12) mI/kg/min. Maximum oxygen consumption was 15,7 (15,2; 18,3) ml/kg/min. The results show the possibility of using the selected duct la research to predict possible complications and post-operative period.
On 10/23 December 1914 four-engine airplanes <<Ilya Muromets>> (Sikorsky aircraft) have been grouped into the <<Squadron air ships>>, which became the world's first heavy bomber compound. This day is not only the date of the appearance of long-range aviation in Russia, but also of its medical service. The first physician in the state of the squadron was Konstantin Finne. He had been the chef of the medical service of the air unit until 1918, when as a result of political turmoil it has ceased to exist. He is the author of the first thorough book on the 4lya Muromets>> and the history of the squadron aircraft airships -. <Russian air warriors Sikorsky>> (1930). In 1903, he graduated from the Military Medical Academy and was left with her to improve. In 1907 he defended his thesis for the degree of Doctor of Medicine. Then he served as a military physician in the military hospital in Riga. The member of the White movement. He immigrated to Yugoslavia, after the World War II to Austria. Since 1949 he lived in the United States (New York), where he died.
Organization of medical equipment supply-for the Russian Army during the First World War. The article shows that when preparing the army for the war and planning of emergency supplies for military time the Russian military department was guided by the experience gained during the Russo-Japanese War, which turned old by that time, and as a result during the First World War the medical service noticed a significant lack of medications,surgical instruments and other medical equipment. There were few bases of medical equipment in the troop district. The undertaken emergency measures allowed improving supply of medical institutions and troops with medical equipment.
Results of the medical support for the international army games <<ArMI-2016>> and the international military-technical forum <<Army-2016>>. It sets out the organizational and methodical bases of medical support massive military-patriotic and cultural events. Obtained its main stages and given their characteristics. The leading role of planning in the organization of medical support measures is presented. The basic disadvantages and the main directions of improving the quality and efficiency of the medical support of public events with the participation of troops are defined.
Use of the accelerated recovery programme after surgical intervention in the field of battlefield surgery. The article provides information on the possibility of implementation of the accelerated recovery programme after surgical intervention in the field of battlefield surgery. According to analysis of experience of work of specialized thoracic reinforcement group at a garrison hospital, transformed into multidisciplinary military field hospital (3rd level), it is shown that principals of the given program may be implemented, under some conditions, in the course of the first emergency specialized aid delivery to wounded on the battlefield. The use of modern technologies in the course of surgical treatment of wounded in battlefield hospital, may reduce traumatic effect of surgical intervention and allows receiving results similar to results received in peacetime during implementation of FTS program, thus to resolve the main state problem - accelerated recovery of the wounded soldiers and their return to the duty or their full social rehabilitation.
The article describes the history of the formation and development of the Branch N 1 of the FGKU <<The main, center of the military- medical examination>> of the Ministry of Defense since the establishment of the military-medical commission of the Moscow military district before its final transformation into the branch. Simultaneously, the article describes the main tasks entrusted to 'the bodies of military medical examination, as well as the performance of this work.