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Polyclinic of the Branch N 6 of the 3rd Vishnevskiy Central Military Hospital celebrates the 40 years anniversary. The history of development^of the policlinic of the branch N 6 of the Federal Government Budgetary Institution <> of the Ministry of Defence, which dates back to 1976, when the 9th clinic of the Moscow garrison was formed. Over the years, repeatedly changed the organizational and staff structure and the name of the clinic (9" consultative-diagnostic polyclinic, polyclinic of the 52,d Consultative Diagnostic Centre MF), continuously improved patient care technology. Currently, the clinic deployed 26 medical-diagnostic branches and offices, with more than 200 employees. Among them, 1 Honoured doctor, 5 candidates of medical sciences, 50% of doctors and 65% of nurses have the highest qualification category. To health care is more than 22 thousand people.

Organisational aspects of medical support for civilians employed in the Armed Forces in the military-medical institutions of the Ministry of Defence, deployed in Moscow. To ensure social protection of the civilian personnel of the Armed Forces is one of the main tasks of the Ministry of Defence of the Russian Federation. In Moscow formed a territorial system of medical support of citizens who have the right for medical care in military medical institutions of the Ministry of Defence of the Russian Federation. Russian legislation does not provide the right for medical assistance provision to the civilian personnel of the Armed Forces in military medical institutions at the expense of funds allocated from the federal budget for the maintenance of the Ministry of Defence of the Russian Federation. The function of the physician in providing primary medical care performs primary care physician. Providing medical assistance to the civilian personnel of the Armed Forces of the Russian Federation in military medical institutions on the basis of their attachment to the clinics onlv the Russian Defence Ministrv. or in the direction of the clinics of Moscow.

The authors present the history of the branch N 6 of the Federal States Organization "the Vishnevsky Central Military Clinical Hospital N 3" of the Ministry of Defense of the Russian Federation, which dates back to November 1, 1974. Over the past years, organizational and staff structure; and the name of the clinic (45th central polyclinic, 45th central consultative-diagnostic polyclinic, 52nd Advisory Diagnostic Center of Defense) has repeatedly changed, but the core the work stays unchangeable--to continually improve patient care technology, to be the leader in the outpatient care for soldiers, reserve officers (retired), members of their families. The. branch consists of 58 medical and 19 specialized diagnostic departments, including 4 hospital departments, 1845 employee work at the branch. Among them 4 doctors of medical science and 43 candidates of medical sciences, 20 honoured physicians and 10 honoured health workers of republic. 70% of doctors and 93% of nurses have the highest qualification category. To health care in the Branch are more than 110 thousand people.

Sleep disordered breathing is an important medical and socio-economic issue. A lot of evidence exists for the impact of sleep apnea on the pathogenesis of cardiovascular diseases, occupational injuries, as well as all-cause mortality. Detection of this type of pathology is challenging due to the complexity and high cost of the procedures. The nocturnal polysomnography was considered as a "gold standard" in the management of any sleep disorders for a long time. However, the development of technology simplified diagnostic equipment and make it possible to diagnose sleep disordered breathing in outpatient department. In this article we reviewed 3-phase approach to the diagnosis and treatment of sleep apnea. Also we describe our own cost-effective experience of implementing of screening examination for sleep apnea in outpatient clinic, using the continuous pulse oximetry monitoring.

Authors analyzed and generalized experience of 2910 anaesthetic supports, performed at the Branch 6 of Vishnevskiy 3rd Central Military Clinical Hospital of Russian Federation Defense Ministry during 2010-2012 in case of outpatient surgery such as endoscopic examinations (gastrofibroscopy, colonoscopy), gynecological support, dental care, ORL-surgery, urologic surgery, diagnostic and treatment arthroscopy. Authors gave information about preoperative, intraoperative and postoperative aspects of outpatient anaesthesia.

The article is concerned with modern methods of assessment of arterial hypertension in patients with metabolic syndrome and characteristics of modern antihypertensive drugs and its combinations necessary for the elderly. The authors gave their own example of treatment of more than 2000 patients with arterial hypertension and metabolic syndrome.

For the purpose of improvement of pharmaceutical benefits for military retirees was designed the drug usage standard. This standard consists of 216 drug titles and is utilized in outpatient care in case of consistency. Monthly outpatient care costs for one military retiree are more than 900 rubles. New procedural and institutional mechanisms, ways of interdepartmental interactions, rational forms of its organization are necessary for the improvement of the effectiveness. These measures correspond to main principals of reorganization of the system of health care.

Psychological personality disorder among former combatants and their relationship to subsequent psychosomatic disorders are examined. For this purpose, in health centers performed clinical and psychological examination of 105 fighters and 100 military personnel who were not taking part in hostilities (control group) aged 27 to 40 years, three groups are outlined: low (24.7%), moderate (64.8%) and high (10.5%) anxiety level, represented by their clinical characteristics. Studies have shown that combat stress can contribute to postreaktive change not only the psyche combatant, but also the development of persistent psychosomatic disorders. The methods and results of treatment and preventive advice are given.

The problems of improvement of outpatient care are considered, methodology of more active implementation of hospitalization technologies, the use of day care, hospital at home is proposed. It is emphasized that the introduction of hospitalization technology makes it less than treatment in hospital costs to improve quality of life for huge numbers of patients.

From February 2007 to March 2010 42 operations concerning the varicose vein disease of lower limbs with magistral valvate inefficiency at the stage of chronic venous insufficiency with the usage of endophleboid laser congelation were performed in clinical outpatient conditions. Diode lasers with wave-length 980 nm. The period of temporary disablement was 14,5 days, after the standard combined phlebectomy with cirsotome--19,5 days. The complications after endophleboid laser congelation in the form of hematomas, burns, sense shock, thrombophlebitis weren't recorded.

The article presents experience of work of surgical units of the 52nd consultative-diagnostic center of MD RF in ingrafting stationary-staying technologies. In the hospital there were realized all necessary conditions for effectuating a wide range of operations of heightened for policlinic level complexity (hospital register). There is a day patient facility, firstly created in medical service of the Armed Forces in 1989. In general during 2003-2008 yy. were effectuated 11724 operations. Were proposed to create territorial centers of ambulatory surgery under big military policlinic institutes, were determined there sphere of duties and principes of functioning.