[Medical support of the Armed Forces of the Russian Federation: the results of the activities and the main tasks for 2015].

Presented the directions of activity of the medical service in the past year, including improving the legal framework, the optimization of medical management software, improving combat and mobilization readiness of units of the army, the optimization of therapeutic and preventive activities, implementation of innovative technologies, increasing mobility of units and subunits, their level of equipping with modern samples of property, training of qualified personnel, intensify research and etc. Analyzed and formulated directions of development of military medicine in 2015, including improvement of combat and mobilization readiness of the management body, military and medical organizations and departments, improving the legal framework of the military health care, holding among the troops interventions for the prevention morbidity of personnel by pneumonia and meningitis, work with commanders at all levels to ensure the preservation and strengthening of health of servicemen, improving of the system of early and active detection of diseases in the military, providing a guaranteed level of care to all contingent Ministry of Defense, improving the quality and accessibility of sanatorium treatment, maintaining constant readiness of medical special forces to carry out tasks for the purpose, improvement of professional training of personnel of the medical service, providing qualitative preparation of government medical service to participate in the training of troops, implementation of unexpected problems, equipping of army medical service with modern medical equipment finishing of the construction and renovation of military medical organizations facilities, improvement of social protection of personnel and many others.

[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.

[The Russian Armed Forces Military Medical Service: condition and ways of improvement].

In 2013 the main efforts of the Medical Service were aimed at the following tasks: optimization of management system of military medical service, improvement of medical evacuation system, medical service security for military contingents, assigned according to territory principle to military-medical facilities of the Ministry of Defence of the Russian Federation, implementation of innovations at all stages of medical evacuation in peace- and wartime, security of combat and mobilization readiness of regulatory bodies of the Medical Service, medical military units and military medical facilities, medical service of troops battle training, improvement of material and technical resources, security of regular pharmacy and equipment supply, activation of research work in the Medical Service interests. Lines of military medicine development in 2014 are: transfer of treatment facilities that are not used by the Ministry of Defence into the Federal Biomedical Agency till the end of 2014, prevention of pneumonia and meningitis in military personnel, improvement of early diagnosis system, medical service for military contingents according to territory principle, improvement of diagnostic and treatment work in military-medical units and subunits and military-medical facilities by means of development of material and technical resources, monitor the implementation of innovative diagnostic and treatment technologies, completion of construction projects of central military hospitals and etc.

[Psychology and psychopathology of information warfare].

Tension of information warfare as a form of modern war has a global character nowadays. Topicality of research of psychological reaction peculiarities and psychopathology phenomena developing during information warfare is determined by necessity of scientific development of the effective means of diagnosis and prophylaxis of these phenomena. The article is devoted to analytical review of modern articles about aim, goals and methods of information warfare, covering some signs of manipulative influence on people's mind. Authors set forward opinion about possible psychological peculiarities and psychopathological consequences of targeted aggressive information influence and also suggest some methods against this influence.

[Ebola virus disease: clinical and diagnostic aspects and organization of treatment-and-prophylactic measures].

The article presents data about world spread of Ebola virus disease, biological characteristics of the pathogen, the laws of the epidemic process in this disease, its pathogenesis, clinical manifestations and diagnosis. Pointed out that the current anti-viral agents, effective for the Ebola virus, have not been developed. Timely performed pathogenetic therapy improves the prognosis of the disease. The basis of this therapy is infusion-detoxification activities and replenishment of losses, of electrolytes, as well as anti-inflammatory and anti-emetic drugs. The Armed Forces of the Russian Federation received the guidelines for preventive measure that can reduce Ebola virus disease transmission. Recommendations for emergency anti-epidemic commission consisted of representatives of the command, specialists and medical services and logistics, are given. Fundamentally important condition for the effective anti-epidemic measures is not only the constant readiness of medical personnel in the detection of disease EVD, but also the appropriate level of equipment of medical institutions of medical supplies and equipment.

[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.

[Medical rehabilitation in the Armed Forces: history, current state and prospects].

Authors analyzed history, current state and prospects of medical rehabilitation in the Armed Forces of the Russian Federation. Current system of medical rehabilitation in the Armed Forces provides all categories of military personnel and members of their families complete rehabilitative and remedial measures. An integration of rehabilitative experience of the medical service of the Armed Forces of the Russian Federation into the State system of medical rehabilitation, active participation of the medical service of the Armed Forces of the Russian Federation in activity of National association of specialists of medical rehabilitation and regenerative medicine will allow to increase the effectiveness of the rehabilitation system of the Armed Forces.

[Prophylaxis of substance abuse in the Armed Forces: organization and performance of screening. Problem of substance dependence disorders is the actual for many countries in the world and affects on health of servicemen].

Due to this fact specialists underline the necessity of implementation of constant drug testing system of servicemen. The most effective researches individuals suffering from substance abuse are sample and control survey. Promising areas of prevention of addictive disease include the use of modem technologies for early detection of drug narcotic drugs and psychotropic substances, using the psychophysiological and laboratory techniques. The most common rapid laboratory procedure is the use of test strips (tablets) based immunoassay analysis. To facilitate the evaluation of the results is increasingly incorporated hardware and software systems based on photometric detection. The work done on the testing of such complexes allowed us to determine the algorithm of screening soldiers to assess the effectiveness of various hardware and software systems and identify promising technologies to identify individuals with addictive disorders.

[About development of All-Russian Service for Disaster Medicine at the present stage].

The information about foundation, development and main areas of activity of All-Russian Service for Disaster Medicine is given. Almost 20 years professional staff members help to save lives and health of people injured in emergency situations in Russia and other countries. There are 81 territorial centers for disaster medicine. The main center is All-Russian center for disaster medicine Zaschita. Its organizational structure, performance indexes including development of information and communication technology, telehealth, organization of firs-aid in a traffic collision are considered. The main ways of improvement of the whole service for disaster medicine including service for disaster medicine of Ministry of Defense are shown.

[Experience of medical support organization of the tank biathlon competition].

Authors presented information about medical support of the tank biathlon competition taking part on 12-17 August 2013 at the Alabino. Crews from Belarus, Kazakhstan and Armenia (The Collective Security Treaty Organization) were invited for the contest. On the basis of the idea of the contest and location of the Alabino, the Main military-medical board of the Ministry of Defence of the Russian Federation developed and passed the Programme of medical support of the contest, gave the word to medical service of the Western Military District and central military-medical facilities about appropriation of funds. Personnel, providing the contest, was training every day during the period of preparation. Over a period of field ambulance station 73 people sought medical advice, 12 of them were sent to hospital. Authors came to conclusion the set tasks were completely fulfilled.

[Improvement of the system of medico-evacuational interventions in the troops with the help of mobile specialized elements].

Taking into account the historical experience the authors considered the main principles of improvement of the system of preventive and curative interventions in the troops with the help of mobile functional elements. The authors suggested to develop medical reinforcement groups which satisfy requirements of high mobility and self-contained operations. 3 types of functional elements must be developed: 17 specialized doctor-nurse teams of the central military--treatment facilities, 10 doctor-nurse teams of district military (navy) clinical hospitals, 11 doctor-nurse teams of branches of district military hospitals. Assignment of air transport with the following reconversion in evacuation transport with the medical air station and medical helicopter station is concerned.

[Methods of substance abuse prevention in the Armed Forces].

Dynamics of substance abuse morbidity in the Armed Forces of the Russian Federation during the last 10 years (2002-2012) was analyzed. Results of performed analysis showed decreasing tendency since 2007 in conscripts (0.07% in 2012) and in contract soldiers (0.3% in 2012). Alcoholism prevailed in the structure of substance abuse in conscripts (0.05%), drug abuses were diagnosed 2,5 times less often (0.02%). In contract soldiers non-alcohol abuses were diagnosed in 0.004% of cases. It is stated that the major aims of substance abuse prevention are qualitative recruiting of military units (especially in troops maintaining the combat readiness) and departments (subunits) of military education, creating conditions for propaganda for healthy lifestyle, prohibition of drugs and psychopharmaceuticals in military units. For early detection of persons liable to substance abuse and facts of drug consumption it is necessary to perform a medical examination with the help of special program apparatus complex (such as "Addicts") and take into account clinical signs of addiction. Besides, it is necessary to introduce planned and unexpected medical examinations of servicemen. Algorithm of measures in case of detection of serviceman with alcohol or drug intoxication is given. In conclusion the main organizational principals of substance abuse prevention in the Armed Forces are given.

[Differential diagnosis of pleural effusions].

The role of clinical and instrumental studies into the nature of pleural effusion obtained through transthoracic puncture was ascertained in 639 with pulmonary pathology. An algorithm was developed for the application of this method to differential diagnosis of different forms of pleuritis. Etiopathogenetic groups of patients with terminal differentiation of this pathology were distinguished.

[Swine flu: epidemiology, diagnostics, treatment, and prophylaxis].

Virus of piggy grippe is a virus of type A, which has greatly changed in it's antigenic structure. As a result, has appeared a new variant of germ (syb-type), in relation to which vaccines, used for period 2008-2009, are unsuccessful. Virus represents a real risk for life and health of millions of people. Experts of World Health Organization are sure, that eruption can lead to a global expansion of virus. To the group of high risk refer: children younger then 5 years old, full-growns of 50 years old and older, children and teen-agers (from 6 months to 18 years), treated for a long time by aspirin, gravidas, full-growns with several chronic diseases, persons in nursing homes, hospices, requiring a long-termed hipurgia, compulsory-duty servicemen. Latent period is from 1 to 7 days (2-3 days on the average). Accountancy of clinical data: acute beginning, hyperpyretic fever, predominance of damages of upper respiratory tracts. The article presents a detailed characteristic of therapeutic and prophylactic measures in the Army and NAVY.

[Correction of mitral regurgitation in conditions of surgical treatment of coronary heart disease].

It was the purpose of this search to announce that elaborating an optimal tactics for patients with coronary heart disease (CHD), complicated with ischemic mitral regurgitation (IMR). There were operated 85 patients with CHD and IMR in the course of 2006-2008. Previously all patients were separated on 3 groups in dependence of severity of IMR, character of damage of coronary race and changing of left ventricle. In the first and the second groups was realized an aorta-coronary shunting with annuloplasty. In the third group was realized an isolated shunting. Mortality in hospital was zero percents. A rudimentary regurgitation was noted by 10% of patients of the 1st group. The maximum period of monitoring was 24 months. Freedom from mitral regurgitation for the 1st and 2nd group was 95%, for the 3rd--93%. So, adequate and mutual estimation of flap-connected factors as well as condition of coronary race by the patients with IMR reduces the risk of by-pass mitral regurgitation and shows good short-term and long-term results.

[System of rehabilitation in the Armed Forces: history, current situation, and perspectives of development].

There are two main directions of development of medical rehabilitation in the Armed Forces of RF for now-days: medical-psychological rehabilitation of military service men among special contingents, realizing special military duty (air- and NAVY-staff, staff duty shift of Missile Force of Special Purpose) and medical rehabilitation of military service men, participants of battle action in accordance with sub-program "Social support and rehabilitation of invalids in consequence of battle action or battle trauma" of Federal Purpose Program in the sphere of social support of invalids. The authors mark necessity of reorientation of medical strategy from evaluation of determination of symptoms of already existent disease to evaluation of determination of adaptation reserves of organism of military service men, determination of changes in organism on the stage of pre-disease.

[Management of medical aid quality and results of activities of an outpatient clinic].

Results of medical aid provided to 3743 patients aged 30-75 (mean 63.8 +/- 13.4) years during 2005-2007 were analysed to evaluate efficiency of the medical care management system (MCMS) in a large outpatient clinic. Criteria of efficiency were the clinical course and outcome of certain diseases. Major medico-statistical indicators of the quality of medical aid were parameters of hospitalization, inadequate care, discrepancy of diagnoses, etc. Materials for the assessment of MCMS were borrowed from the questionnaires filled up unanimously by health care professionals and patients as requested by a specially developed guideline after their informed consent was obtained.

[Work algorithm for a chief medical officer in territorial health care delivery services to the troops].

The authors envisaged the order of emplacement, tasks, duties, rights and responsibility of chief medical officers of the Defense Ministry of Russian Federation, accented the importance of work planning on the base of clinical-epidemiological analyze and monitoring of morbidity, necessity of cooperation of chief medical officers inter se. Main attention must be paid to military units of medical service. The purpose of it--is further their integration in territorial system of medical maintenance.

[Main directions of realization of strategy of social development of the Armed Forces of Russian Federation up to the 2020th year].

Latter years the president and the government more and more pay attention to the questions of social evolution of the Army and Navy, augmentation of the level of social protection of military staff, discharged and members of their families. But a great number of problems of military-social sphere are not yet resolved. Presented Strategy is a complex document of long termed character. The strategy defines concrete purposive results in the sphere of social evolution of the Armed Forces for the period up to 2020th year; check list of the main measures and the mechanism of the control of their's realization. In the frames of Strategy there was elaborated a such program, as "Improvement of medical supply of the Armed Forces for the period 2008-2020", which includes 15 subprograms: "AIDS-infection in the Armed Forces", "Tuberculosis in the Armed Forces", "Prevention and treatment of cardiovascular diseases in the Armed Forces", "Improvement of material-and-technical base of military-medical units", "Health survey and propaganda of orthobiosis", "Prophylaxis of dental diseases", and others. Now-days there was created a working group, it's continues the elaboration of the plan of realization of measures of Strategy.