bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative characteristics of patients with arterial hypertension and stenosing atherosclerosis, depending on the localization of the pathologicalprocess in the vascular bed
Authors: Kryukov E V , Potekhin N P , Fursov A N , Zakharova E G
Published: July 2021

A comparative analysis of the clinical and functional state of patients suffering from arterial hypertension is given, depending on the localization of vascular stenosis of atherosclerotic origin. It is shown that stenosing atherosclerosis often affects men with hypertension. Lesions of the brachiocephalic arteries and renal arteries in patients suffering from arterial hypertension are detected at a younger age than with other localizations. Patients suffering from lesions of the coronary and brachiocephalic arteries are characterized by the presence of concentric left ventricular myocardial hypertrophy and hyperlipidemia. In patients suffering from damage to the renal arteries, leg arteries, and multivascular pathology, myocardial hypertrophy is eccentric, in addition, they have atherogenic dyslipidemia and significant signs of renal dysfunction. An excessive decrease in blood pressure at night is most often recorded in people suffering from coronary atherosclerosis, and its excessive increase in patients suffering from damage to the arteries of the legs. Arterial hypertension in patients with stenosing atherosclerosis in most cases is well-mediated, however, with stenosis of the renal arteries and with multivascular lesions, it is less likely to achieve a level of «normal» or «high normal» systolic blood pressure than with damage to other vascular pools. Significant differences in the levels of both systolic and diastolic blood pressure in all comparison groups indicate a different effect of local hemodynamic disturbances on systemic blood pressure.
Etiological characteristics of acute respiratory diseases in servicemen of the Western military district in 2014-2019
Authors: Gorenchuk A N , Kulikov P V , Zhogolev S D , Aminev R M , Kuzin A A , Rubova S R , Zhogolev K D , Sidorenko S V , Nikitina E V
Published: July 2021

The species affiliation of respiratory pathogens isolated from patients and carriers in the military units of the Western Military District in 2014-2019 was studied. The analysis of long-term and seasonal dynamics of their circulation is carried out. It was found that S. pneumoniae and adenoviruses are more often detected in acute respiratory diseases in conscripts. The genetic material of adenoviruses was found in 31,9% of samples, influenza viruses in 13,3%, rhinoviruses in 11,2%, respiratory syncytial viruses in 1,7%, metapneumoviruses in 0,9%, parainfluenza viruses 0,7%, bocaviruses0,5%, coronaviruses 0,1%, S. pneumoniae 33,9%, H. influenzae 13%, M. pneumoniae 9%, C. pneumoniae - in 3,3%, N. meningitidis - in 16%. Comparison of the results of work with studies carried out by domestic research groups among the civilian population in the same period showed that the circulation of various respiratory viruses depends on the year, season, and is also influenced by socio-demographic factors. A direct high functional correlation was found between the dynamics of circulation of adenovirus and S. pneumoniae in different years and epidemic seasons. Evidence has been obtained of the active implementation of the process of self-maintenance of the reservoir of infections and the multifactorial nature of the overall environmental sustainability of the system in organized military teams. In the etiological structure of respiratory infections, the proportion of pathogens varies depending on the season in different years, the characteristics of the formation and composition of organized groups, as well as epidemic periods.
Theory of hibernament ensembles and the possibility of its use to ensure life activity for extremal impacts
Authors: Ushakov I B , Komarevtsev V N , Sapetsky N V , Sapetskiy A O , Timofeev N N
Published: July 2021

The possibility of efficient use of the theory of hibernation ensembles to ensure vital activity in extreme conditions is considered. Hibernation ensembles are strictly selected sets of tools, among which are special combinations of pharmacological preparations and hypostabilizers, respiratory mixtures different in gas composition, controlled hypothermia, etc., which, when coordinated, cause the formation of a special state of the body, referred to as «hypobiosis and cryobiosis» or artificial hibernation. The data of experimental studies on changes in the body’s resistance to the extreme effects of gamma radiation, to acute hypobaric hypoxia and to flight overloads under conditions of artificially induced hibernation are generalized to determine the possibility of using the theory of hibernation ensembles while ensuring vital activity under extreme influences. It is shown that under the influence of vegetotropic agents against the background of hypothermia, the metabolic processes slow down significantly and the organism of warm-blooded animals begins to acquire ambient temperature. The condition that occurs in this case is accompanied by an increase in the body’s resistance to extreme factors, such as acute hypobaric hypoxia, deep hypothermia, exposure to ionizing radiation, toxic lesions, massive blood loss, pain shock, etc. This area of research is of particular relevance for the development of methods for long-term life support person in extreme conditions, with severe injuries and in the provision of medical care in conditions of mass admission victims, since it provides a reserve of time necessary for organizing the safe transportation of victims to the places of specialized and high-tech medical care, that is, actually providing medical care at a later date.
Fabrication of human Wharton’s jelly extra cellular matrix for tissue engineering
Authors: Kalyuzhnaya L I , Chernov V E , Frumkina A S , Chebotarev S V , Zemlyanoy D A , Tovpeko D V , Kosulin A V
Published: July 2021

The development of tissue engineering is based on the use of the extracellular matrix as a construct to which cells migrate and attach for proliferation, differentiation, and long-term functioning. The preparation of the matrix is one of the most important tasks, since it must be non-immunogenic, have optimal mechanical properties, contain cell adhesion molecules and growth factors and degrade at the predicted time. The search for biomaterial for the manufacture of the matrix is limited by a number of circumstances. Tissue-specific for the matrix intravital biomaterial is limited, cadaveric is not acceptable due to age-related changes or diseases that reduce the regenerative capacity of tissues; synthetic materials lack cell adhesion molecules or are not degraded. The umbilical cord is an accessible homologous biomaterial of non- embryonic origin, preserving the features of the embryonic phenotype. The optimal method of decellularization of the Warton jelly of the human umbilical cord in the manufacture of a full-component cell-free matrix is substantiated. Umbilical cord decellularization was carried out using a detergent method with a 0.05% sodium dodecyl sulfate solution for 24 hours. The quality of the decellularization was evaluated microscopically by staining with fluorescent dye and quantification of nucleic acids. The gentle method used to remove cells from the Warton jelly tissue meets the existing criteria for the effectiveness of decellularization, since only single cells and a small amount of deoxyribonucleic acid remain in the processed biomaterial. The technique does not provide centrifugation at high speeds, in which glycosaminoglycans and proteoglycans are lost from the matrix, the enzymatic action that destroys fibrillar collagen structures, and non-physiological conditions of decellularization. The therapeutic success of tissue-engineering structures based on the extracellular matrix will depend not only on the bioactivity of the umbilical cord, but also on the safety of the composition, structure and mechanical characteristics of the matrix. Due to the availability and non-invasiveness of receiving from healthy young donors, provisional organs are an excellent source of homologous biomaterial for matrix production.
Willingness to understanding and cooperation of people of other faiths and views with young men in various ethnic language groups
Authors: Uliukin I M , Berezovskiy A V , Orlova E S , Pavlova N V
Published: July 2021

Аbstract. In our days, representatives of various cultural traditions and principles of living arrangements are forced to share one geographical space. This rapprochement, as shown by real behavioral experience, does not always proceed peacefully and calmly. Interethnic (intercultural) tension, up to and including open confrontation, ethnocentrism, xenophobia - all this testifies to serious problems in modern social relations. Tolerance indicators were studied in 129 practically healthy young men (average age 22,98±1,92 years) of various ethnic-speaking groups using the «Tolerance Index» questionnaire, which determines both the general attitude to the outside world and other people, and social attitudes in different areas of interaction where tolerance and intolerance of a person are manifested (ethnic tolerance, social tolerance, tolerance as a personality trait). The average level of general tolerance in all groups is shown, which reflects an adequate approach to the selection of candidates for training. The revealed significant differences in the indicator of general tolerance between some groups are due to psychological differences dictated by ethnocultural dissimilarity and an individual, depending on upbringing and education, sociological approach to emerging problems). Indicators of ethnic tolerance, social tolerance and tolerance as personality traits are also of an average nature, since all the individuals examined had approximately the same social status. The combination of a person with both tolerant and intolerant traits, manifesting themselves depending on social situations, must be taken into account during the educational process.
Myocardial reperfusion syndrome. Pathogenesis, clinic, diagnosis
Authors: Khubulava G G , Shishkevich A N , Mikhailov S S , Bessonov E Yu
Published: July 2021

The basics of pathogenesis, clinic and diagnosis of myocardial reperfusion syndrome are considered. Myocardial reperfusion syndrome is defined. Its relevance as one of the most poorly studied and formidable complications of cardiac reperfusion in myocardial infarction with elevation of the S-T segment has been explained. A brief review of the historical review of this problem and such types of manifestations of myocardial reperfusion syndrome as: diastolic myocardial dysfunction, post-reperfusion disturbances of the heart rhythm, the phenomenon of no-reflow and irreversible damage to the myocardium are briefly reviewed. The modern views on the pathological physiology of diastolic myocardial dysfunction, post-reperfusion damage to the myocardium, and the no-reflow phenomenon are analyzed. A review of current views on the pathological physiology of the development of post-reperfusion disturbances in heart rhythm is carried out. The clinical picture and the effect on the hemodynamics of such a manifestation of myocardial reperfusion syndrome as diastolic myocardial dysfunction are described. A brief description of the clinical picture of irreversible post-reperfusion damage to the myocardium is given. The clinical picture and types of post-reperfusion rhythm disturbances are described. The diagnostics of the no-reflow phenomenon has been analyzed in detail, the coronary angiographic scales for assessing thrombolysis in myocardial infarction and for assessing myocardial perfusion are graphically shown. A description of the basics of diagnosing post-reperfusion disturbances in heart rhythm, diastolic myocardial dysfunction, and post-reperfusion irreversible damage to the myocardium is given. A brief description of the known in the world literature predictors of the development of myocardial reperfusion syndrome is presented.
Atypical rolandic epilepsy spectrum and related conditions
Authors: Sofronov A G , Zaytsev D E , Titov N A , Zaytsev I D
Published: July 2021

In the last decade, a sufficient amount of data has accumulated that testifies to the ambiguity of the assertion about the «benignity» of benign childhood epilepsy with centro-temporal commissures («Rolandic»). More and more researchers are providing evidence of cognitive impairment associated with age-dependent epilepsy. A literature review is given on this problem, the main trends and main criteria the diagnosis of typical and atypical age-dependent epilepsy with centro-temporal commissures on the electroencephalogram are considered. It has been established that the main criteria for the atypical nature of age-dependent epilepsy include such signs as the intermittent focus of slow waves, multiple asynchronous peak waves, long peak wave clusters, generalized 3 Hz «absance-like» runs, the relationship of interictal paroxysms with negative or positive myoclonus, and abundance interictal finds during wakefulness and sleep. A continuum of conditions associated with the condition under consideration is highlighted, which includes a number of conditions from relatively favorable to severe and disabling. We have singled out the term «atypical rolandic epilepsy», which has already taken shape in the world literature and includes such signs of atypicality as: early debut of seizures (up to 4 years), the presence of daytime seizures, duration of seizures (more than 30 minutes), with a tendency to form status, changes in neuroimaging studies (both morphological - computed and magnetic resonance imaging - and functional - positron emission tomography), impaired cognitive and / or behavioral sphere (including Indra attention deficit hyperactivity disorder), disorders of motor development as well as the mental and speech development, atypical manifestations in the electroencephalogram (unusual localization rolandic spikes, their generalization, the presence of «3Hz absansopodobnyh runs»).
Anton Wolfler - forgotten genius of surgery
Authors: Sigua B V , Zemlyanoy V P , Danilov A M , Mavidi I P , Zakharov E A , Nesvit E M , Melnikov V A , Kalandarova D Kh , Zemlyanskay A Yu
Published: July 2021

Nowadays, when surgery as a science was so rapidly developed, the names of many scientists who stood at its origins are forgotten or rarely mentioned, and their contribution remains underestimated. One of them is the innovator of surgery of the XIX century. Czech scientist Anton Welfler, whose bold ideas have spread far beyond the boundaries of abdominal surgery. Unfortunately, for many he is known only as the author of the methodology for the formation of gastroenteroanastomosis and as a student of Theodore Billroth. However, in reality, A. Welfler made an incomparably greater contribution not only to gastric surgery, but also to herniology, thyroid surgery. The result of his study of embryogenesis, the histological structure of the thyroid gland, his own clinical experience gained two monographs, subsequently recognized as fundamental in this section of surgery. He developed a histological classification of thyroid cancer, for the first time described both solid and cystic forms of papillary cancer. He also suggested the possible mechanisms of carcinogenesis. Together with Theodore Billroth A. Welfler introduced the technique of total thyroidectomy into clinical practice. Widely used in modern surgical practice, gastroenteroanastomosis with the loop of the small intestine turned off and the U-shaped inter-intestinal anastomosis, named after Caesar Roux, was in fact, developed by A. Welfler in the experiment. Caesar Roux himself noted A. Welfler’s priority in the invention of this design. In 1897, Caesar Roux modified the method of A. Welfler, forming a posterior-free version of this operation.
Criteria for assessing renal allograft dysfunction
Authors: Lavrishcheva Y. V. , Yakovenko A. A. , Belskykh A. N.
Published: July 2021

The significance of the glomerular filtration rate calculated by the Cockcroft - Gault formula as one of the highly sensitive criteria for assessing renal allograft dysfunction is substantiated. The study demonstrated that in the group of patients with an increased level of daily proteinuria there is a significantly lower level of serum creatine in comparison with the group of patients with a normal level of daily proteinuria. Moreover, in patients with a normal level of daily proteinuria, there are significantly higher values of glomerular filtration rate calculated by the Cockcroft - Gault formula, compared with patients with an increased level of daily proteinuria. Thus, it is shown that the level of serum creatinine currently used in clinical practice, as a laboratory marker of renal allograft dysfunction, does not allow to detect impaired renal allograft function at the earliest possible date. It has been demonstrated that the glomerular filtration rate calculated by the Cockcroft - Gault formula is a highly sensitive and specific laboratory marker of renal transplant dysfunction. Determining the glomerular filtration rate calculated by the Cockcroft - Gault formula makes it possible to diagnose renal allograft dysfunction at the earliest stages, which will significantly improve the survival of the transplanted kidney due to timely changes in patient management tactics and correction of immunosuppressive therapy.
Assesment of premarure death in patients with pulmonary tuberculosis and chronic obstructive pulmonary disease
Authors: Katicheva A. V. , Brazhenko N. A. , Brazhenko O. N. , Chuikova A. G. , Zheleznyak S. G. , Tsygan N. V. , Nikolau A. V.
Published: July 2021

The risk of developing cardiovascular pathology and premature death from it in patients with pulmonary tuberculosis in combination with chronic obstructive pulmonary disease is assessed. It has been established that more than 80% of patients with pulmonary tuberculosis are regular tobacco users. Chronic tobacco intoxication leads to the formation of chronic obstructive pulmonary disease, affecting the course of the tuberculosis process. In patients with tuberculosis on the background of smoking and chronic obstructive pulmonary disease, pronounced clinical manifestations of the disease are determined, which are accompanied by a common tuberculosis process, decomposition in the lung tissue and bacterial excretion. Patients suffering from comorbid pathology revealed deep disturbances in the homeostatic balance of the body and changes in the reactivity of the body. Changes in the proteinogram were determined, with the predominance of g - и -2 fractions, an increase in C-reactive protein and fibrinogen, which confirms a pronounced systemic inflammatory response. The pathological state of homeostatic equilibrium of the body is accompanied by the development of hypoxemia, oxidative stress, systemic inflammation, endothelial dysfunction and dyslipidemia. In a third of patients, changes in the lipid profile are determined against the background of a lack of body weight, which is an unfavorable prognostic sign during chronic obstructive pulmonary disease. Such phenomena contribute to the development of multifocal atherogenesis, systemic arterial hypertension, cardiac remodeling and the rapid development of cardiovascular pathology. In patients with comorbidity, changes in the electrocardiogram are characterized by remodeling of the myocardium, a change in the position of the electrical axis of the heart, overload of the right heart, hypertrophy of the left heart. These patients are characterized by a decrease in exercise tolerance, a moderate and high risk of developing cardiovascular complications and premature death from them. Identified changes are predictors of early disability and premature death of patients with tuberculosis, contribute to a decrease in the quality and life expectancy of patients.
Impaired heart conduction in pilots of civil aviation of the older age group
Authors: Kuzmina A. Y. , Blaginin A. A. , Fisun A. Ya
Published: July 2021

Prevalence, structure and clinical significance of conduction disturbances was studied according to the electrocardiography findings in 1189 older pilots in aged 55 years and older, who were to the Central Civil Aviation Hospital (Moscow) and examined on the regular bases. Resting electrocardiogram was recorded in all subjects according to generally accepted methods. Heart conduction disorders were detected in 16,9% of pilots of the older age group. More common were intraventricular conduction disturbances - 13,7% of cases, atrioventricular conduction disturbances were recorded less often- 1,8% of cases, and their combination was even less common - 0,6% of cases. Cardiac conduction abnormalities as part of another electrocardiogram syndromes were noted in 10 (0,8%) peoples. Older civil aviation pilots are characterized a lower frequency of electrocardiogram changes compared to a general population of the same age in the Russian Federation. The signs of cardiac conduction disturbances on the electrocardiogram in civil aviation pilots did not always lead to unfitness to fly. The evaluation of fitness to flight in some electrocardiogram deviations is depend of the presence or absence of cardiovascular disease, functional condition of the cardiovascular system and the data of additional examination methods. Diagnosis of heart rhythm and conduction disorders is important in assessing the state of the circulatory system, especially in flight personnel. Timely detection of cardiac conduction disorders in civil aviation pilots is essential for maintaining medical safety, especially in older people. Electrocardiography is performed as an initial method for assessing the state of the conducting heart system in civil aviation pilots.
Late silicosis - the rare form of pneumoconiosis
Authors: Halimov Yu. S. , Tsepkova G. A. , Vlasenko A. N. , Shilov V. V. , Andreenko O. N.
Published: July 2021

A clinical case of a relatively rare variant of pneumoconiosis, late silicosis, which developed 25 years after the termination of contact with fibrogenic dust, is described. The patient was examined at the consultative and outpatient department of the North-West Scientific Center for Hygiene and Public Health (the clinical base of the Department of Military Field Therapy of S.M. Kirov Military Medical Academy). It was established that the patient worked for 15 years as a crusher at a mining and processing plant, where the work was accompanied by exposure to dust of fibrogenic action (granite gneiss) containing free crystals of silicon dioxide, noise, vibration and an unfavorable microclimate, and also worked as a repairman for 12 years where it was exposed to abrasive dust, noise and adverse climate. In the general assessment of working conditions, taking into account the combined and combined effects of harmful factors, they are considered harmful to the crusher (class3.3) and acceptable to the crusher / repairman (class 2.0). For the entire period of work of this employee, occupational diseases were not established and he was not referred to a professional pathologist. Based on the study of a professional history, data on the sanitary and hygienic characteristics of working conditions, the results of a clinical examination, including physical and laboratory methods, spirography, fibrobronchoscopy, radiography and computed tomography of the lungs, a diagnosis of late silicosis was established.
Immunoprotective therapy of suppression of humoral immune response, pain induced (search for narcotic analgesics with immunoprotective activity)
Authors: Aleksandrov V. N. , Kondratenko A. A. , Mikhailova E. V. , Kromsky S. V. , Sidorin V. S. , Sigareva L. P. , Eliseeva M. I. , Gorichny V. A. , Pak N. V. , Slizhov P. A.
Published: July 2021

Problematic issues of prevention of humoral immune response suppression induced by pain in conditions of the experimental model of severe mechanical trauma are highlighted. It has been established that one of the pathogenetic factors of trauma depressing the humoral immune response is pain. Thus, drugs inhibiting intra-central transmission of afferent impulse, and, in particular, narcotic analgesics, may be considered as drugs with immunoprotective activity. Evaluation of the immunoprotective activity of five narcotic analgesics administered immediately after trauma to immunized mice in the first 24 hours of post-traumatic period showed the presence of the estimated effect in morphine hydrochloride, fentanyl and pifurben. By 106 splenocytes of mice received these preparations and immunized on the first day after the trauma, reliably more antibodies forming cells are formed in mice in comparison with their number in animals received after the trauma as narcotic analgesics intermediol and dipidolor. Thus, morphine hydrochloride, fentanyl and pifurben, i.e. drug analgesics with immunoprotective activity, should be considered as the preferred drugs in the group of narcotic analgesics in emergency care for patients with severe trauma. The use of narcotic analgesics with immunoprotective properties should be considered as one of the measures in the complex of measures aimed at the prevention of post-traumatic immunodeficiency and infection in an immunocompromised host. Infections are difficult to diagnose and often with an unfavorable outcome.
New approaches to the selection of genetic markers associated with multifactorial phenotypic traits
Authors: Kutelev G. G. , Krivoruchko A. B. , Trandina A. E. , Ivanov A. M. , Cherkashin D. V. , Marchenko A. A. , Grishaev S. L.
Published: July 2021

Modern approaches to searching for associations between the studied phenotype and structural variations of the human genome are analyzed. Most complex phenotypic traits, including diseases, do not follow the laws of Mendelian inheritance, but have a multi-factor nature, that is, a significant contribution to their development is made by the genetic component in combination with the influence of environmental factors. In General, there are several approaches to the design of a limited set of polymorphic markers for point genotyping. Selection of individual molecular genetic markers is carried out based on either their statistically significant Association with the studied multivariate feature, or their functional significance for the implementation of this feature. The candidate gene approach allows you to focus on one or more polymorphic variants in the region of a gene (allelic variant), the product of which is likely involved in the development of a disease or trait. The cheaper procedure for full-genome screening using ultra-high-density microchips has made available another approach for searching for genetic predispositions - full - genome Association search. We believe that the unification of both approaches into a single algorithm for the choice of molecular genetic markers to conduct point genotyping will allow for both markers selected based on a priori assumptions about the functional significance of candidate genes, and Association with the studied trait on the basis of genome-wide associations search. This approach will optimize the diagnostic efficiency of the created test suite.
Induction of the remission of immune thrombocytopenic purpura
Authors: Odin V. I. , Lehthlaan-Thynisson N. P. , Zolotarev A. D. , Mineeva N. V. , Polyakov A. S.
Published: July 2021

Abstract. A review of the literature on remission of immune thrombocytopenic purpura in children and a retrospective analysis of its course in a young patient who was successively applied, first to no avail, standard drug therapy, and then, due to the lack of effect, a physiotherapy technique based on the principles of activation therapy. It is known that immune thrombocytopenic purpura is a rare acquired autoimmune disease characterized by isolated thrombocytopenia with the occurrence of hemorrhagic syndrome of varying severity, which can lead to fatal bleeding. At the same time, antiplatelet antibodies are detected only in half of patients suffering from immune thrombocytopenic purpura, and therefore are not a necessary criterion for diagnosis, which in turn makes it difficult to diagnose the disease and does not allow them to be used as a criterion for the effectiveness of treatment. Despite the fact that in childhood, most cases of immune thrombocytopenic purpura occur in acute form, often with the development of spontaneous remission, but in a significant part of patients, relapses of the disease are accompanied by significant thrombocytopenia, hemorrhagic syndrome, and a decrease in the quality of life, which requires specific therapy up to splenectomy. When using the Reverse wave technique in the treatment of immune thrombocytopenic purpura, a stable, long-term remission was achieved in a young patient. The prospects of studying the application of this physiotherapy technique in clinical practice are discussed.
Determination of the level of condensate by recording the noise level in the respiratory circuit of mechanical ventilation devices
Authors: Geraskin I. V. , Geraskin V. A. , Geraskina N. V.
Published: July 2021

Abstract. The method of determining the accumulation of condensate by registering the noise level in the respiratory circuit of ventilators is substantiated. According to the proposed method, the condition and performance of the apparatus is monitored during artificial lung ventilation and oxygen therapy. With hardware ventilation, an increasing turbulent flow of a water or gas stream is formed in the respiratory circuit, accompanied by an increase in the noise effect and vibration. An increase in the level of acoustic noise from fluctuations in the accumulation of condensate in gaseous media was recorded by an instrument for objective measurement of sound level a sound level meter. Indicators of noise effects reached a higher level on the wet circuit (the presence of condensation droplets or accumulations of mucus) of the liquid compared with the indicators obtained on the dry breathing circuit. The difference in recorded noise levels reached 10 dB, and increased from 37,73 to 47,36 dB. Areas of the respiratory circuit with the greatest degree of narrowing of the lumen and critical accumulations of water condensate and mucus are a source of turbulence in the air flow and increased noise. In conditions of prolonged artificial ventilation of the lungs, the rate of humidified air-gas flow is constantly changing, especially with hardware modeling of the phases of inspiration and expiration, and an increase in temperature in the humidifier chamber. The proposed technique is designed to identify critical levels of water condensate in the apparatus breathing circuits by recording the intensity of the increase in noise level and choosing the rational mode of operation of medical equipment. Data on the emerging critical situation are displayed on the sound level meter screen and inform medical personnel about the need to rehabilitate the circuit of the artificial lung ventilation apparatus. The primary field of application is resuscitation and intensive care units, medical transport teams during in-hospital or inter-hospital transportation, and surgical operating rooms during inhalation anesthesia.
The Years of the Potential Life Lost due to Breast Cancer Assessment Results in St. Petersburg Population
Authors: Orlov G. M. , Romanenkov N. S. , Movchan K. N. , Botyan A. Yu. , Senkov R. E. , Bahtin M. Yu. , Zharkov A. V. , Yakovenko O. I. , Gedgafov R. M. , Rusakevich K. I.
Published: July 2021

Abstract. Data analysis contained in the official forms of medical statistics allows us to state that in St. Petersburg in 20112012 yr. 8% breast cancer incidence increase and 6% mortality rates decrease in women were noted. Years of potential life lost due to breast cancer in 2012 yr. among St. Petersburg female residents in aged 30 to 64 years decreased 8% compared with 2011 yr. data (2632 and 2435 in 20112012, respectively). Years of potential life lost due to breast cancer in 20112012 yr. decreased 16% (1101 and 948 in 20112012 yr. respectively) in St. Petersburg women aged 50 to 59 years (group of maximum incidence rate among patients with malignant neoplasms of the mammary glands). The results of medical care assessment providing to breast cancer patients in St. Petersburg over the past 9 years has allowed to state the positive dynamics in the anticancer fight effectiveness. In 20112018 yr. the incidence of breast cancer in women in St. Petersburg increased by 28,2% (from 45,670/0000 in 2011 yr. to 58,580/0000 in 2018 yr.), and the 5-year survival rate of patients with breast cancer in St. Petersburg increased by 4,9% (from 60,4% to 63,4% in 2011 and 2018 yr. respectively). Considering these data the number of years of potential life lost due to breast cancer in the analyzed period decreased. This circumstance can be regarded as one of the indicators of the medical care quality in breast cancer patients and as an indicator of the proper organization of oncological service functioning in the administrative and industrial center of Russia.
Prospects for the development of inhalation drugs for the provision of pre-hospital assistance to affected by hazardous chemical substances
Authors: Ivanov I. M. , Nikiforov A. S. , Yudin M. A. , Sventitskaya A. M. , Pavlova V. S.
Published: July 2021

Abstract. Pharmacological agents are analyzed, in respect of which it is advisable to develop dosage forms for inhalation use as medical means of protection at the prehospital stage of medical evacuation in case of damage by emergency-hazardous chemicals. It was found that the inhalation intake of hazardous chemicals, especially with a pronounced pulmonotoxic, irritating and generally poisonous effect, is highly likely to develop post-intoxication complications associated with damage to the lung parenchyma, and death. For the therapy of such intoxications, it is advisable to administrate drugs in a dosage form for inhalation administration, which have several advantages: high bioavailability, rapid onset of effect, and severity of local action in various parts of tracheobronchial tree. The data of experimental and clinical studies of the effectiveness of drugs belonging to various pharmacological groups allow us to recommend for the further development of inhaled forms of means of prevention and treatment of toxic pulmonary edema (fluticasone, roflumilast, rolipram). Bronchodilators and donors of sulfhydryl groups (ipratropium bromide, tiotropium bromide, atropine sulfate, fenoterol, salbutamol, formoterol, unitiol dimercaprol) are referred to means of correction of respiratory disorders of various etiologies. Diazepam, midazolam, clonazepam, lorazepam are considered to be the most likely anticonvulsants from the enzodiazepine-class suitable for inhalation. Acetylcysteine, hydroxycobalamin can be used to combat hypoxia. The principal possibility of inhalation application of bioscavengers (acetylcholinesterase, butyrylcholinesterase) for the treatment of cholinopositive symptoms of toxic genesis is shown. Existing methods and means of delivery allow the use of these drugs at the prehospital stage of medical evacuation as part of single dose metered powder inhalers.
Irritants: a modern redefining of relevance to the armed forces and the prospect of creating medical means of protection
Authors: Kuzmin A. A. , Ivchenko E. V. , Seleznev A. B. , Sidorov S. P. , Yudin M. A.
Published: July 2021

Absract. Arguments are presented in favor of the increasing relevance of irritants to ensure the fulfillment of tasks by military personnel of the Armed Forces of the Russian Federation, as well as the need to reassess the risks to human health arising from their use. The results of an information-analytical data on methods and adverse effects of irritant application for purposes which are not prohibited by the Convention on the Prohibition of the Development, Production, Stockpiling and Use of Chemical Weapons and on Their Destruction are presented. Modern ideas about molecular mechanisms of the effect of irritants on structures of the nervous system are considered, which are based on the fact that the provocative effect of irritants is realized by changing the permeability of cation channels of the transient receptor potential of type A1, expressed at the ends of sensitive neurons. The results of experimental and clinical studies of specific modulation of these channels using their natural and synthetic antagonists are analyzed. Structural formulas and basic pharmacological characteristics of the most active antagonists are given and the prospect of their use as a basis for the development of drugs for the treatment of irritant lesions is substantiated. The data on the use of solutions based on amphoteric and chelating agents for emergency treatment of skin areas infected with irritants is presented. A number of promising areas of research on the creation of effective medical means of protection against lesions by irritants has been identified.
History of pancreatic cancer surgery
Authors: Sigua B. V. , Zemlyanoy V. P. , Lataria E. L. , Zakharov E. A. , Rakita S. Yu. , Lee K. A.
Published: July 2021

Abstract. The first mention of pancreatic cancer dates back to 1761, when the six-volume work of the famous Italian anatomist G. Morgagni On the location and causes of diseases discovered through dissection was published. However, the history of surgical treatment of malignant tumors of the pancreas dates back to the end of the 19th century. The accumulated experience of operational techniques and the introduction of aseptic rules created objective prerequisites for performing operations in complex anatomical zones during that period of time. On July 16, 1882, the famous German surgeon F. Trendelenburg, firstly, performed a successful resection of the tail of the pancreas for sarcoma, founding the development of surgery in this field. However, the success in this sphere could not be shifted to a tumor of the head of the gland due to the subsequent separation of the duct system from the duodenum. Over the following years, many outstanding surgeons tried to solve this problem, such as: A. Codivilla, W. Halsted, W. Kaush, until in the early 40s A. Whipple proposed a new method of pancreatoduodenal resection, that became the gold standard for head cancer treatment pancreas. Although it was not possible to achieve significant success in the treatment of cancer in the original method of operation, as a result at various stages of time this procedure wasnt used a lot and was almost forgotten. Today, surgery remains the leading method in the complex treatment of patients with pancreatic cancer. Minimally invasive technologies have been actively introduced into pancreatic surgery in the past two decades. The indications for surgery have been expanded, lymphadenectomy standards have been introduced, thereby increasing the chances of a successful cure.
On the occasion of centenary of the birth of I.I.Deriabin (1920–1987)
Authors: Samokhvalov I. M. , Tiniankin N. A. , Matveev S. A. , Suprun T. Yu. , Liashedko P. P. , Bechik S. L.
Published: July 2021

Abstract. On the 2nd of August, 2020 marked the 100th anniversary of the birth of the famous Russian surgeon, the Head of War Surgery department of the Academy, professor, Major-General of the Medical Corps Ilia Ivanovich Deriabin. I.I. Deriabin was the participant of the Great Patriotic War and the war against militarist Japan, the warfare in Afghanistan, the first postwar postgraduate fellow under professor S.I.Banaitis, a student and associate professor of A.N. Bercutov, an officer working many years at War Surgery department, Kirov Military Medical Academy. I.I. Deriabin was also the Head Surgeon to the Group of Soviet Forces in Germany, the founding principal of War Surgery department at the Military Medical faculty, Moscow Central Institute for Advanced Medical Education, Deputy Chief Surgeon of the Soviet Army. In the history of military medicine professor I.I. Deriabin will stay as a great scientist and organizer in the field of War Surgery, a founder of traumatic disease tactical treatment concept, the author of the idea of medical-transport immobilization (anticipating popular modern tactics Damage Control). He also came up with an idea of an improvised frame for unstable pelvic fracture immobilization, developed the technique of peritoneal dialysis (in cooperation with M.N. Lizanets and E.V. Chernov), devised (coauthored with A.C. Rozhkov) multicomponent anti-inflammatory local wound blockade for injury control and septic complications prevention.
Practical recommendations for prevention of development and progression of hypertension among the flight personnel of the Russian Aerospace forces
Authors: Trishkin D. V. , Schegol’kov A. M. , Makiev R. G. , Fisun A. Ya. , Polovinka V. S. , Gornov S. V. , Cherkashin D. V. , Kutelev G. G. , Gornov V. V.
Published: July 2021

The article substantiates the relevance of studying the problem of early development and progression of hypertension among the flight personnel of the Russian Aerospace forces. The article analyzes the incidence of hypertension among aircrew in comparison with the incidence in the Armed forces and the population of the country. The article considers the most significant signs of early development and course of hypertension, which lead to early disqualification from flight work for medical reasons. The total risk of developing cardiovascular complications is assessed on the scale for assessing the risk of fatal cardiovascular disease over 10 years in the examined individuals with previously established and newly detected arterial hypertension and high levels of stress. Attention is drawn to the high prevalence of modifiable risk factors for cardiovascular pathology among the examined individuals against the background of occupational stress. It was found that people with diagnosed hypertension under the influence of a high level of professional stress are characterized by irrational changes in eating behavior, high prevalence of Smoking, increased alcohol consumption and low physical activity. In addition, stress-induced hypertension indicates a high risk of developing cardiovascular complications in the next 10 years and necessitates additional expansion of the range of measures for its prevention and correction. Practical recommendations for preventing the development and progression of hypertension among the flight personnel of the Russian Aerospace forces are presented. These recommendations are based on the analysis of the incidence of hypertension in flight personnel at the present stage, as well as the identified risk factors for developing hypertension, taking into account the specifics of flight work and conditions of military service of these specialists.
Comprehensive rationale for the use of immune plasma for septic patients
Authors: Skripay L. A. , Vilyaninov V. N. , Skripay A. A.
Published: July 2021

Data of accounting and reporting documents of the Center (blood and tissues) are analyzed retrospectively) the Kirov military medical Academy for the period from 2017 to 2019 on the use of blood components in septic conditions of patients in clinics of the Kirov Military medical Academy. The volume of issued immune plasma for patients suffering from septic complications in 2017, it was 154 doses (33,9 l), in 2018, it was 196 doses (43,1 l), in 2019, it was 389 doses (72,1 l). It was found that in patients suffering from septic complications on the second day after transfusion of blood components, the levels of the studied indicators of the inflammatory process did not change unambiguously. Thus, in patients who received immune plasma transfusion, there was a decrease in white blood cells by 1,5109/l on the next day after the component was transfused. At the same time, there was a direct decrease in rod-shaped neutrophils, monocytes, erythrocyte sedimentation rate and a decrease in body temperature. In patients who were transfused fresh frozen plasma, white blood cells increased by 0,5109/l and slightly monocytes. A slight decrease in platelets in septic patients of group 1 after transfusion of immune plasma indicates the active participation of these cells in the reactions of antibacterial immunity. This can be considered as a favorable prognosis for a particular patient, since there is a direct relationship between the decrease in the number of platelets and the duration of stay in hospital treatment, as well as the overall outcome of the disease. The level of circulating immune complexes in patients of both groups after transfusions of blood components remained within normal values. Levels of fibrinogen, prothrombin, and albumin changed significantly in each group. At the same time, the level of fibrinogen after transfusions increased, and prothrombin changed in different directions. In the treatment of patients, the use of immune plasma activates the system of cells of the bodys antibacterial defense and improves the positive dynamics in treatment. In modern economic realities, testing plasma samples to suppress the growth of microbial colonies is justified, since it helps to reduce the volume of transfused blood components for severe septic patients.
Anatomycal features of the ethmoidal labyrinth and nasal cavity structures in childhood
Authors: Markeeva M. V. , Aleshkina O. Yu. , Tarasova N. V. , Gaivoronsky I. V.
Published: July 2021

The morphotopometric variability of the ethmoidal labyrinth and the parameters of the nasal cavity for 87 childrens cranium (121 years) has been determined. The growth of the ethmoidal labyrinth and the nasal cavity occurs undulating and unevenly. The increase of the height of the ethmoidal labyrinth begins earlier than its width and length from 23 years to 1316 years old. Growth periods the height of ethmoidal labyrinth occur for 23 years, 812 and 1316 years; widths 47, 812 and 1721 years; length 47, 812 and 1316 years. At the ethmoidotomy in the infant and early childhood, the smallest size of the ethmoidal labyrinth should be taken into account: width 78 mm, height 1416 mm, length 2729 mm, so in these age periods there is a high risk of damage of the cribriform and orbital plates ethmoid bone with the development of iatrogenic complications. The nasal cavity штchildren expands posteriorly as well as in adults. In the infancy, the width of the nasal cavity at the back corresponds to the width in the front section, from 2 years prevails than in front and by adolescence becomes larger for 33,5 mm. Knowing these agerelated features of the structure of the childrens nasal cavity, during surgery the rhinosurgeon when shifting the middle nasal shells medially or laterally should ensure to maintain the physiological model of the nasal cavity. In infancy, the width of the ethmoidal labyrinth is larger than the width of the nasal cavity by 38,5%, and by adolescence this ratio increases to 76,8%. The length of the nasal cavity increases from 47 years to adolescence, the length of the ethmoidal labyrinth grows parallel to the maximum length of the nasal cavity and it is less for more than a half in all childrens age groups: in the infancy by 74%, in adolescence by 85.1%. The height of the nasal cavity is twice the height of the labyrinth in any childhood age, the distance from the bottom of the nasal cavity to the lower edge of the middle nasal shell must be correlated with the distance above the level of the average nasal shell during intranasal surgeries and do not exceed it for the introduction of tools.