[Possibilities of application of modern training methods (project activities) in training health care organizers on the example of a military medical educational organization].

The efficiency of health care and the quality of medical care can be improved by implementing modern management methods and technologies. It requires modern and high-quality training of medical management personnel. Qualified personnel are the key factor in the organization and transformation of the health system. Human resources ultimately ensure the efficiency and effectiveness of the entire health sector. Requirements to economic management methods are changing and increasing, and specialists with skills in managing medical organizations at different levels of the healthcare system are becoming in demand. At the level of the constituent entities of the Russian Federation, the role of medical personnel who possess strategic methods of healthcare management is increasing. Available training programs in leading higher educational institutions of medical profile do not fully fulfill these tasks due to limited time, a large volume of lecture material, and frequent changes in the conditions and tasks of health care. These problems can be solved by optimizing training programs for retraining and advanced training of health care organizers, introducing active training methods such as business games, case methods, and project activities into the curriculum. The paper describes the system of training students for training courses in the field of healthcare and public health through planning and implementation, project management in the context of military educational organizations of the Ministry of Defense of the Russian Federation, the statistical analysis of the training effectiveness, the factors that influence the success of development programs.

[Non-infectious morbidity in the Armed Forces (a review on results of the round table in the State Duma)].

The article presents the results of the medical service of the Armed Forces of the Russian Federation on prevention of non-infectious diseases among the military, the results reported on May 12, 2016 at the meeting of the Committee for the Protection of Health of the State Duma of the Federal Assembly of the Russian Federation. Attention paid to the fact that the Armed Forces are an integral part of society and the state, and therefore the negative trend in the health status of the population are also reflected in the troops. In the common-ness of non-communicable diseases in the Armed Forces have an influence, especially of military service. Consider an organization and legal framework to combat non-communicable diseases in the Armed Forces successes in this direction, problematic issues and their solution.

[Pecularities of organisation and health care delivery to military servicemen under conditions of mid- and high mountains].

The authors present an analysis of adverse climatic factors mid- and high mountains, which have a significant negative impact on fighting facility and capacity for work in military servicemen that may cause an acute mountain sickness and severe complications (high altitude pulmonary edema and high-altitude cerebral edema). Complicated mechanisms of organism disorder are shown. Sophisticated medical and tactical factors of mountain theatre of war, defining the nature of actions of troops, require special approaches to organisation of medical support. One of the major tasks of the medical service and the commanders is the timely prevention of health disorders troops in mountainous terrain.

[Stiffness of the arterial wall and predicted vascular age as a predictor of cardiovascular disease when stress-induced hypertension in the military personnel].

Stiffness of the arterial wall and predicted vascular age as a predictor of cardiovascular disease when stress-induced hypertension in the military personnel. On the basis of the study of 156 men aged 30-55 years are considered diagnostic methods for stress-induced hypertension in the military personnel. Furthermore, using modern diagnostic methods determined stress effect on the development of stress-induced hypertension, and also the risk of cardiovascular diseases. In order to detect early signs of atherosclerosis used sphygmography, by means of which was determined by cardio ankle vascular index (CA VI), as well as the calculated vascular age. The study proposed a set of organizational, diagnostic and therapeutic measures to reduce the risk of cardiovascular diseases among military personnel exposed to occupational stressful load.

[Evaluation of myocardial perfusion by single-photon emission CT in the treatment with beta-adrenoblockers and calcium channel blockers].

Single-photon emission CT of the heart was used to observe coronary blood flow and reveal the maximum perfusion region in patients with coronary heart disease (CHD) treated with beta-adrenoblockers and calcium channel blockers. Dynamic observation showed changes and redistribution of myocardial perfusion. Specific features of coronary blood flow were demonstrated depending on the therapeutic modality (beta-blocker metoprolol, calcium channel blocker amlodipine). Parameters of prognostic value were identified depending on the effectiveness of the agents used. This approach together with the traditional nosological one to the choice of CHD therapy permits to individualize the therapeutic influence depending on myocardial micriocirculatory features, such as the spread and depth of perfusion disturbances.

[The cytoprotective role of endogenous heat shock proteins during the treatment of patients with acute coronary syndrome].

The study involving 48 patients with the preliminary diagnosis of acute coronary syndrome aged 54-78 years included analysis of clinical, laboratory and instrumental data for subgroups with different definitive diagnosis (myocardial infarction and unstable angina in 28 and 22 patients respectively). On the whole, the mean content of HSP-70 at admission averaged 2.1 ± 0.3 ng/ml and decreased to 1.6 ± 0.4 ng/ml (p < 0.05) after therapy. In the subgroup with myocardial infarction, the HSP-70 level (1.6 ± 0.4 ng/ml) was significantly lower than in patients with unstable angina (2.1 ± 0.3 ng/ml); p < 0.05. The reduced HSP-70 level associated with a severe myocardial lesion gives evidence against the hypothesis of these proteins as markers of myocardial dysfunction whereas a rise in their content at the onset of ischemic process suggests their protective role.

[Ballistocardiography as a part of cardiac function research].

Provided an overview of materials on the history of the formation method ballistocardiography for diagnosis of cardiovascular disease, an assessment of its current status and prospects for further development. Investigation of the physiological changes in the myocardium by recording ballistocardiogram acquires greater relevance since the existing knowledge in the field of cardiac diagnosis were obtained using instruments that do not meet modern requirements. Although the results of previous studies and define the basic characteristics ballistocardiography nonetheless update and clarification of details in relation to the data obtained by the use of modern methods of measuring contractility of the myocardium, it is useful. The resumption of work on the development of reliable devices for ballistocardiography is an urgent task. Method ballistocardiography under military medicine may be used for the integrated assessment of the functional state of the cardiovascular system during clinical examination of servicemen during mass examinations of recruits, the selection of students in military schools, as well as in monitoring the hemodynamic status in a hospital.

[Hi-tech health care: modern status and prospects of development in medical facilities of the Ministry of Defence].

The article is devoted to the current issues of providing hi-tech medical care in hospitals of the Ministry of Defence. Since the beginning of 2013 the executive body of the Russian Ministry of Defense pays special attention to improvement of the quality and accessibility of health care contingent of the Ministry of Defence. Thus, according to decision of the Minister of Defense of the Russian Federation, General of the Army Sergei Shoigu in 2013 more than 1.1 billion rubles (in 2012, targeted funding of high-tech medical care in the Ministry of Defence did not materialize) was allocated for military medical institutions of the Ministry of Defense of the Russian Federation to provide high-tech medical care. As a result, in 7 months in 2013 the volume of medical care has increased by 32% in comparison with the same period in 2012. Currently the main military medical department of the Ministry of Defense is working to resolve the order of delivery and financing hi-tech medical care in the Armed Forces in the following areas: inclusion of military medical institutions of the Ministry of Defence in the list of health organizations, providing high-tech medical care, approved by Order of the Ministry of Health of the Russian Federation, legal regulation of the provision of high-tech medical care in military medical establishments of the Ministry of defense of the Russian Federation within the budget appropriation allocated to the Ministry of Defence.

["Diver's lung": features of respiratory system remodeling in Navy aquanauts in long-term period after deep saturation dives].

It is established that after the termination of deep saturation dives reorganization of respiratory system at navy aquanauts proceeds. This remodeling is specific, atypical for natural age dynamics.

[Dynamics of echocardiographic index in aquanauts during the period of long-term effects of deep diving (to 500 m)].

The authors presented the echocardiography and doppler sonography of aquanauts during the period of long-term effects of deep diving (to 500 m). According to the analysis of the given data the following was revealed: imperceptible atrium distensibility, left ventricular concentric remodeling without myocardial hypertrophy, saving of general and regional myocardial contractile function, left ventricular diastolic dysfunction grade 1, intact right ventricle, orthoarteriotony in pulmonary artery, change of size and distensibility of the aortic root. The authors came to conclusion that there are 2 different process in the structural ventricular remodeling during the period of long-term effects of deep diving--envolving myocardial consolidation and heart chamber dilation. These two processes is connected with temporary factor atypical for natural age dynamic. The aortic root has a atherosclerotic change and distensibility. There is no further dynamic distensibility. The abovementioned changes in heart and aorta can progress in aquanauts, which have too many dives. Patients in the study group haven't dived over the years, but nevertheless have the abovementioned changes.

[Use of SPECT-scanning of the heart in estimating of influence of drugs of the background therapy of ischemic heart disease on myocardial perfusion].

Some new facts about the influence of different groups of drugs on myocardial perfusion were educed during the research. Educed facts conduce representation extension by matching the optimal therapy of ischemic heart disease. With the help of SPECT-scanning were educed myocardial blood flow, areas of maximal hypoperfusion and its influence on time pattern and redistribution of myocardial blood flow in patients receiving disease-modifying agents and statins. Some regularities of change of myocardial blood flow depending on applied group of drugs and peculiarities of influence of myocardial perfusion in certain time interval were revealed. Criteria with prognostic significance in prospective individual effectiveness of anti-ischemic drugs were pointed out. New approach, based on choice of anti-ischemic therapy depending on extent of influence on myocardial perfusion and also individual clinical and functional traits of patients, was applied.