bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of the provision of paradontology in the Armed forces of the Russian Federation
Authors: Nikitenko V. V. , Grebnev G. A. , Chernysh V. F. , Kovalevsky A. M. , Sheenko L. I.
Published: July 2021

A statistical study of the appeal to the dental clinic of S. M. Kirov Military Medical Academy patients who were diagnosed with chronic generalized periodontitis, as well as the analysis of treatment methods for inflammatory periodontal diseases in the Armed Forces based on data from the Main Military Medical Directorate for 2012-2018. Analysis of treatment methods for chronic generalized periodontitis in the military unit indicates the choice of a radical method - tooth extraction. Most patients who applied to the clinic of maxillofacial surgery and surgical dentistry were diagnosed with a severe degree of chronic generalized periodontitis. Basically, patchwork operations were performed on the upper jaw and lower jaw. The proportion of patients with moderate severity of chronic generalized periodontitis prevailed in the dental clinic. In the conditions of the dental clinic, no flap periodontal operations were performed, most often the method of curettage of periodontal pockets was used, which was carried out to improve the quality of the intervention according to classical recommendations in the field of several teeth, including using high-tech equipment. Timely and high-quality comprehensive treatment of inflammatory periodontal diseases is the basis for successful activities to reduce periodontal morbidity and improve oral health in military personnel. Due to the relevance of inflammatory periodontal diseases in the Armed Forces of the Russian Federation, the choice of treatment method should be based on etiological and pathogenetic therapy, dentists should abandon the radical method of tooth extraction.
Tactics of surgical treatment of patients with lumbar spondylolysis
Authors: Nadulich K. A. , Khominets V. V. , Nagornyi E. B.
Published: July 2021

The bilateral defect of the pars interarticularis (spondylolysis) is often the cause of low back pain syndrome and can lead to development of spondylolistesis. In some cases inefficiency of conservative treatment of this condition forces orthopedists to use surgical technologies. At the same time, in young patients with intact intervertebral discs, the rigid segmental fixation of the spine should be avoided. Where no neural decompression is needed, selective osteosynthesis of the pars defect is an optimal technique. The authors present the results of surgical treatment of 15 patients with single and two-level lumbar spondylolysis, 4 of which revealed minimal I degree lytic spondylolystesis of the L5 vertebrae. Localization of the pathological process in all patients was noted on both sides. In two patients spondylolysis defects of two vertebrae were detected (in one- adjacent L4 and L5, in the other - L2 and L4 vertebrae with sacralization of L5). The average period from the onset of symptoms ranged from 6 months to 2 years (an average of 14 months). All patients undergone bone autoplasty with iliac crest bone graft, and osteosynthesis of vertebral arches by a combined laminar-transpedicular system of the screw - rod - hook type. All patients had excellent and good anatomic and functional results. The used method of surgical treatment of patients of this category should be considered pathogenetically justified, as it is aimed at repair of spondylolytic defects as the main cause of segmental instability and forward displacement of vertebrae. The possibility to avoid fixation of intact segments of spine allows to categorize this operation as organ-preserving.
Dental rehabilitation of total adentia at pensioners of the Ministry of defense and contingent attached to military medical organizations
Authors: Muzikin M. I. , Grebnev G. A. , Iordanishvili A. K. , Tereshchuk S. V. , Melnikov M. V.
Published: July 2021

Legal, economic and clinical aspects of treatment of military personnel, retired military personnel, as well as the attached contingent in the conditions of hospitals of the Ministry of defense are presented. The study is based on the results of studying the number of dental implants installed in patients from 2014 to 2019 based on the medical records and outpatient records of a dental patient in two specialized departments of multidisciplinary hospitals of the Ministry of defense of the Russian Federation. Primary medical records were studied, data on the sex and age of patients, the presence (absence) of opportunistic diseases used implant system, the installation of dental implants and their amount and frequency of soft tissue and osteoplastic operations (to increase the volume of the bone and soft tissues of the alveolar bone (part) jaws) and the Protocol of the temporary and permanent prosthesis. Based on the analysis, we describe the current possibilities of medical and diagnostic work and present various types of orthopedic structures on dental implants for the dental rehabilitation of the above-mentioned contingents with complete adentia of the jaws (including in cases where absolute indications require the removal of all teeth due to foci of chronic odontogenic infection or periodontitis). The methods of treatment of patients in cases of combination of adentia with varying degrees of atrophy of the alveolar processes (parts) of the jaws are analyzed in detail. Clinical examples of dental rehabilitation are shown both with and without the use of methods for increasing the volume of jaw bone tissue, using various modern protocols for fixing orthopedic structures on zygomatic and root dental implants, and the frequency of their use in military medical organizations of the Ministry of defense of the Russian Federation during the reporting period. Based on the presented results, it is shown that the military medical organizations of the Ministry of defense of the Russian Federation have a full range of opportunities to provide comprehensive dental care to patients with complete secondary adentia, even in the presence of extreme bone atrophy of the jaws.
Pathogenetic factors of trauma and post-traumatic immunodeficiency
Authors: Alexandrov V. N. , Kondratenko A. A. , Mikhailova E. V. , Kromsky S. V. , Sigareva L. P. , Eliseeva M. I. , Pak N. V. , Gorichnyi V. A.
Published: July 2021

It is well known that the severe condition of patients can be caused not only by shock, but either by epiphenomenon of post-traumatick shock, mestly pulmonary, quite often ending by death, as a manifestation of a successful treatment- resistant secondary post-traumatic immunodeficiency. On our deep persuasion, based on the analysis of literature, and afterwards own experimental data, pathogeny of post-traumaticimmunodeficit at the level of organism and according to its pathogenetic prophylaxis can not be unsealed without the analysis of reaction of the immune system on the pathogenetic factors of trauma: 1) inadequate (foremost pain) impulsation from the damaged fabrics; 2) blood-plasma loss 3) entering blood of bioactive substances; 4) hypoxia. What are the immunomodulatory effects of these factors, not at all, but in case of specific mechanical injury? What is the specific contribution of each factors to the development of immunosuppression in case of specific injury, which one is the main pathogenetic factor in the pathogenesis of post-traumatic immunodeficiency? There are no publications about the specific role of known pathogenetic factors of trauma in the formation of post-traumatic immunodeficiency. The available data gives an idea about the role of pain afferentation, stress, blood loss, toxemia, hypoxia in modulating the immune response in general, regardless of any type of trauma, and the primary changes in the immune system of patients after assistance, including surgical intervention bearing the risk of developing immunosuppression along with drug therapy. The study of these problematic issues of the pathogenesis of post-traumatic immunodeficiency at the system level in the context of severe mechanical trauma experimental model is provided with sufficient understanding of significance of urgent and adequate assistance in the context of ideas about the role of pathogenetic factors of trauma in the pathogenesis of post-traumatic immunodeficiency.
Assessment of the prospects for introducing drug insurance into military healthcare as part of project activities
Authors: Fisun A. Y. , Miroshnichenko Y. V. , Shcherba M. P. , Golubenko R. A.
Published: July 2021

It is shown that one of the priority areas of the social policy of the Russian Federation is the consideration of improving the drug supply, the rationale for the national drug policy, as well as the introduction of the drug reimbursement (insurance) system, as one of the key mechanisms to increase the affordability of drugs by partially or fully reimbursing their cost citizens when providing medical care on an outpatient basis. It was revealed that in the context of reforming the healthcare system, the specifics of the work of power ministries and departments are not sufficiently taken into account. In this regard, the features have been studied and an assessment has been given of the prospects for introducing drug insurance into military health care as part of project activities, as one of the mechanisms for implementing interagency cooperation in modern socio- economic conditions when reforming drug supply. It is reflected that the introduction of drug insurance mechanisms can increase the availability of drugs, have a positive effect on the health of the assigned contingents, and reduce the frequency and duration of hospitalizations. At the same time, the following were identified as the main prospects and systemic prerequisites for implementation: the need to create a reliable legal basis for the formation and subsequent development of a unified state system of drug supply, taking into account the specifics of military health; transition to a rational system of financing drug supply for the provision of medical care on an outpatient and inpatient basis as part of a project to develop a new model for the provision of primary health care and specialized medical care based on a unified medical and technological hospital base; prospective reduction of expenses for the supply of medical care in stationary conditions; optimal distribution of rights and responsibilities, ensuring coherence between health authorities; prevention of duplication, ensuring equal and guaranteed drug supply for citizens as part of the project to ensure the quality and accessibility of medical care to privileged contingents of the Ministry of Defense of the Russian Federation. A possible model of drug supply for contingents attached to military medical organizations is substantiated when providing medical care on an outpatient basis when introducing a drug insurance system at the state level. The following key elements of a grounded model are described: adjustment of drug supply management; clarification of the categories of assigned contingents; optimization of the order of dispensing of drugs; the formation of restrictive lists of drugs; optimization of financing.
Contemporary problems of professional activity of anesthesiologists-resuscitators
Authors: Klyukovkin K. S. , Kochorova L. V. , Okulov M. V. , Kozhin S. A.
Published: July 2021

The results of studying the opinions of anesthetists-resuscitators on topical issues of the implementation of their professional activities are presented. A total of 450 doctors were interviewed in St. Petersburg and 450 doctors in other regions of the North-West Federal District. It was found that 68,8% of anesthetists-resuscitators received specialized training in anesthesiology-resuscitation immediately after graduating from a medical university and work by vocation. At the same time, their professional activity is associated with increased workload (about a third of specialists work with workloads of up to80-90 hours a week), including psycho-emotional work (57,4% of respondents experience constant stress, 45,6% have chronic diseases, resulting from professional activities). The main directions of optimizing the conditions of their activity, doctors call both financial (raising wages, equipping with modern medical equipment), and organizational measures (optimizing the balance of work and rest, reducing the load). 61% of doctors working in St. Petersburg would not want to change jobs, in other regions only 27,6% of respondents would not want to change anything, and 15,5% plan to change their medical specialty. Among the positive aspects of their work, doctors unanimously noted the factors of emotional comfort: the ability to help people, a good work team, and a convenient work schedule. Doctors consider tension and fatigue, wage mismatch with the workload, and lack of legal protection as negative sides. Given the high degree of commitment of resuscitation anesthetists to their profession, adaptation to difficult conditions, the main efforts should be directed to measures to attract and retain medical personnel, optimize the required volumes and forms of advanced training, introduce a system of psychological adaptation of specialists to working conditions, development of legal support measures for doctors.
Professional important abilities of aviation doctor that necessary for medical support of flight safety
Authors: Trofimenko S. V. , Annenkov O. A. , Blaginin A. A.
Published: July 2021

Professionally important qualities of aviation doctors that have a direct impact on flight safety have been investigated. It was established that in the practice of an aviation doctor out of 200 professionally used bathrooms, only 99 turned out to be professionally important and noted as desirable. Of these, 26 competencies are necessary. It was found that out of 99 desirable professionally important qualities, organizational qualities are one of the main (30,3%) and become the main and determining (53,8%) of the 26 necessary professionally important qualities. The latter included: a high level of responsibility for the work performed, a small impossibility, the ability not to succumb to someone elses influence, especially on the part of reputable persons, discipline, demanding, the ability to defend his point of view before the command, integrity, readiness and ability to accurately perform the prescribed actions and instructions, the ability not to prevent himself from working even to immediate superiors. Also, among the 26 necessary professionally important qualities, the second most important for flight safety are the qualities characterizing cognitive processes (15,4%), and the qualities characterizing knowledge (11,5%) become the third. The absence of negative moral attitudes such as the admissibility of material remuneration for professional services in addition to wages and a tendency to dependent behavior (gambling, psychostimulants, alcohol intake, tobacco smoking, Internet addiction, sexual or food dependence) plays an important role in the practical work of the aviation doctor. At the same time, the presence of such personality features as risk propensity and acceptance in relation to people are undesirable in medical safety assurance of flights.
Stem cells: an origin and marks
Authors: Moskalev A. V. , Gumilevskiy B. Y. , Apchel A. V. , Cygan V. N.
Published: July 2021

The basic physiological functions of stem cells are given: the ability to reproduce and generate offspring, which are manifested at the level of the population, and not of a single cell. The manifestation of these functions depends on the quantitative and qualitative composition of the microenvironment. Stem cells consist of two fundamentally different types: pluripotent, which exist only in vitro (in vitro) and tissue, existing in the postpartum body (in vivo). Stem cells can be replaced without limitation in vitro and lead to the appearance of a wide range of cell types. Tissue stem cells under normal conditions do not generate cells characteristic of other types of tissue. Stem cells include cells capable of expressing the gene products characteristic of them. However, there is no universal marker to differentiate stem cells from non-stem cells. A key marker of pluripotency is the transcription factor - a pituitary-specific transcription factor is positive. A component that can be found in almost all types of stem cells is the telomerase complex. Another stem cell marker is called CD34 glycoprotein. The functional activity of stem cells is associated with a molecular marker referred to as leucine-rich repeat containing G-protein bound to receptor 5. However, other types of cells do not express this marker. The physiological capabilities of stem cells depend both on the cells themselves and on their environment. The most reliable way to identify stem cells is to determine their phenotype in vivo. This suggests that stem cells do not carry a universal molecular marker. Most likely, they have significant differences from transplanted cells, and these differences cannot always be detected in individual cells, but only at the population level.
Justification of the form and necessity of creating and maintaining a sepsis register
Authors: Gumilevsky B. Y. , Ivanov F. V.
Published: July 2021

The results of large multicenter epidemiological studies of sepsis indicate a tense epidemiological situation and important microbiological features inherent in each medical institution. Together with the abundance of clinical information necessary for making a diagnosis and assessing the severity of a patient with sepsis, these facts dictate the need to create and maintain a septic register - a system for collecting, recording and storing unified information about patients with a specific disease receiving a specific treatment. The multifaceted nature of the sepsis problem leaves an imprint on the features that need to be given to the sepsis register. It is important that the prospective registry takes into account the microbiological, immunological and clinical aspects of sepsis. The uniqueness and variability of the microbiological landscape of a particular intensive care unit and intensive care unit suggests that each medical institution needs to maintain its own sepsis register, taking into account the data of microbiological monitoring. Also, the prospective registry should contain a detailed clinical description of each case entered into it, including all the necessary laboratory data to assess the severity of the patients condition in dynamics. The creation and implementation of the registry in medical institutions will allow you to own the epidemiological situation in sepsis, monitor patients throughout their lives, analyze the adequacy of the therapy and timely correct it, as well as carry out timely diagnosis and correction of the long-term consequences of the disease. Due to individual characteristics, each medical institution needs to create and systematically maintain its own sepsis register.
N.I. Pirogov and his proverbial: «I believe in hygiene»
Authors: Zholus B. I. , Petreev I. V.
Published: July 2021

The great doctor, anatomist, surgeon, teacher, professor Nikolai Ivanovich Pirogov (1810-1881) glorified not only Russian medicine, but also Russia as a whole. His discoveries and achievements relate primarily to the anatomy and its topographic direction, surgery and its military field, the military medical administration is the organization of medical support for the army. The vast majority of scientific results were achieved by Professor N.I. Pirogov during his work at the Imperial Medical and Surgical Academy from December 1840 to July 1856. Among all his wonderful quotes and expressions, the words I believe in hygiene and The future belong to preservative medicine gained the most popularity. They were published in Russian in his fundamental work The Beginnings of General Military Field Surgery, Taken from Observations of Military Hospital Practice and Memoirs of the Crimean War and the Caucasian Expedition in 1865. For more than 150 years, these phrases continue to be quoted by doctors of many specialties. . The question of what meaning Nikolay Ivanovich invested in these winged words and served as the reason for this article. To understand the great scientists judgments, his words individuality and fatalism, which preceded these historical phrases, are analyzed. The sources of knowledge and experience of hygiene of the first half of the XIX century, which N.I. could use Pirogov since, until 1865, neither in Europe nor in Russia did hygiene acquire the status of an independent science, its provisions were based on empirical information received by doctors in both peacetime and wartime. With full confidence, it can be argued that the highest authority of N.I. Pirogov and his catch phrase I believe in hygiene served as a powerful incentive for the development of all hygiene science.
Association of arterial hypertension gene polymorphisms with the risk of sudden cardiac death in young people
Authors: Kachnov V. A. , Tyrenko V. V. , Kolubaeva S. N. , Cherkashin D. V. , Kutelev G. G. , Myakoshina L. A. , Buntovskaya A. S.
Published: July 2021

Abstract. The frequency of occurrence of arterial hypertension genes in individuals at risk of sudden cardiac death was studied. The relationship between risk factors for sudden cardiac death and the presence of polymorphisms of arterial hypertension genes was revealed. There was a high incidence of homozygous risk variants AGTR2 AA and CYP11B2 TT-polymorphisms responsible for the development of left ventricular hypertrophy, including in young individuals. A correlation was found between deaths in close relatives under 50 years of age and the presence of polymorphisms in the CYP11B2 344 CT gene in young people at risk of sudden cardiac death. We have obtained data indicating the feasibility of conducting a study of the polymorphism of the CYP11B2 gene in the presence of a risk of sudden cardiac death. A direct correlation was found between the presence of fatal outcomes in relatives under 50 years of age by the mechanism of sudden cardiac death and the number of homozygous variants of arterial hypertension genes. Mathematical models for predicting the presence of polymorphisms in genes responsible for the possibility of arterial hypertension are constructed. Among the constructed mathematical models, the most informative were models for detecting carriers of mutations in the genes ADD1 1378 GT, CYP11B2 344 CT and NOS3 894 GT. The expediency of the analysis to search for mutations of arterial hypertension genes, especially in the CYP11B2 344 CT gene, for the possibility of earlier and more intensive preventive measures in young people is shown. The data obtained indicate that there are relationships between the risk of sudden cardiac death, some known predictors of its occurrence, and the genes for arterial hypertension.
The original modification of Albrecht – Staveley operation in the treatment of Wilkie’s syndrome
Authors: Sigua B. V. , Zemlyanoy V. P. , Kachiuri A. S. , Melnikov V. A.
Published: July 2021

Abstract. Presents a clinical case of the treatment of a patient suffering from Wilkies syndrome. Wilkies syndrome (aorto-mesenteric compression of the duodenum) is a compression of the duodenum (its horizontal section) between the abdominal aorta and the superior mesenteric artery. The causes of this disease are asthenic constitutional type, sharp weight loss, etc. A natural complication of Wilkies syndrome is the occurrence of a chronic violation of duodenal patency. The method of choosing treatment for aorto-mesenteric compression is surgery. The most optimal volume of surgery is the formation of duodenojejunoanastomosis according to Albrecht Staveley, however, after this intervention, there is a high risk of a vicious circle syndrome. Patient M., 28 years old, who was scheduled for treatment, noted constant pain in the upper abdomen for 18 years, aggravated after eating, nausea, periodic vomiting, weakness. As a result of the examination, the patient revealed aorto-mesenteric compression of the duodenum. According to multispiral computed tomography of the abdominal organs with contrast at a distance of 40 mm from the mouth of the superior mesenteric artery, a horizontal branch of the duodenum is located between it and the aorta, its diameter at this level is no more than 4 mm, the angle of departure of the superior mesenteric artery from the aorta is 17 degrees. Violation of the passage through the duodenum was confirmed by fluoroscopy of the upper gastrointestinal tract with contrast. The patient underwent surgery. As a method of surgical treatment, an original modification of Albrecht Staveley operation was used, which, in addition to achieving the main goal, is aimed at preventing the development of the vicious circle syndrome. The patient was discharged from the clinic on the 10th postoperative day in satisfactory condition.
Epidemiological aspects of malaria in the Astrakhan region for the period from 1996 to 2019
Authors: Arakelyan R. S. , Irdeeva V. A. , Gasanova E. D. , Abrosimova L. M. , Shendo G. L. , Kurbangalieva A. R. , Karpenko G. A.
Published: July 2021

Abstract. The epidemiological situation of malaria incidence in the Astrakhan region from 1996 to 2019 is analyzed. During this period, 163 cases of human malaria were registered in the Astrakhan region. The largest number (134 (82,2 %)) cases of malaria were reported between 1996 and 2002. Since 2002, there has been a downward trend in the incidence of malaria from 11 (6,7%) in 2002 to 1 (0,6%) in 2019. Cases of malaria were registered between the ages of 5 months and 70 years, including 41 (25,2%) children aged 5 months to 17 years and 122 (74,8%) cases in adults. At the same time, 91 (74,6%) adults employed in various industries were in the group of people of working age. Three-day malaria was registered in 153 (93,3%) people, 8 (4,9%) people tropical malaria and 1 (0,6%) four-day and ovale-malaria, respectively. In the Astrakhan region, 141 (86,5%) people registered imported malaria from both the Commonwealth of Independent States and the African continent. In addition to imported malaria, 11 (6,7%) cases reported secondary malaria from imported malaria. The percentage of repeat cases was 11 people. All cases of malaria were diagnosed on the basis of epidemiological history, clinical picture and laboratory studies. Thus, in recent years, isolated cases of imported malaria have been registered in the Astrakhan region. Both children and adults are susceptible to the disease. Malaria was imported to the Astrakhan region mainly from Azerbaijan, Tajikistan and countries of the African continent.
Endoscopic transversus abdominis release separation in the treatment of patients with midline incisional hernias
Authors: Burdakov V. A. , Zverev A. A. , Makarov S. A. , Strizheletsky V. V. , Rutenburg G. M. , Matveev N. L.
Published: July 2021

Abstract. The issues of reconstruction of the anterior abdominal wall in patients with median postoperative ventral hernias remain relevant for many years. The paradigm of their treatment is gradually shifting towards functional minimally invasive reconstructions of the anterior abdominal wall. The indications and technical aspects of endoscopic posterior separation surgery are considered. The analysis of 70 transversus abdominis release was carried out. The average age of patients with postoperative ventral hernias was 61,210 years. The median follow-up was 14,28,2 months and the anaesthesia risk was 2,80,5. The mean hernia width was 151,773,7 cm2 and the implant size was 832,9243,3 cm2. In the early postoperative period complications were observed in 7 (10%) patients, including the one with retromuscular hematoma, four with retromuscular space infection and two with superficial vein thrombophlebitis. Late complications were observed in 6 (8,7%) patients, there were persistent seroma (3) and chronic pain (3). No hernia recurrence was detected during this period. Thus, the use of endoscopic abdominal wall separation reduces the risk of local complications compared to similar open surgery. At the same time, there is a low level of hernia recurrence and a satisfactory quality of life. In total there were 70 (100%) transabdominal preperitoneal plastic transversus abdominis release and endoscopic totally extraperitoneal transversus abdominis release operations performed, among them 14 (77,8%) were bilateral transversus abdominis release and 32 (61,5%) were unilateral transversus abdominis release 4 (22,2%) and 20 (38,4%) respectively were transabdominal preperitoneal plastic transversus abdominis release and endoscopic totally extraperitoneal 10 (14,3%) operations with combined access were performed: 3 (16,7%) and 7 (1,5%) respectively transabdominal preperitoneal plastic transversus abdominis release and endoscopic totally extraperitoneal transversus abdominis release. In 13 (18,6%) cases simultaneous operations occurred, including 7 (10%) laparoscopic cholecystectomy and 6 (8,6%) endoscopic inguinal hernioplasty.
About the effectiveness of cell technologies in extensive soft tissue defects plasty
Authors: Fistal E. Ya. , Popandopulo A. G. , Soloshenko V. V. , Movchan K. N. , Romanenkov N. S. , Yakovenko O. I. , Gedgafov R. M.
Published: July 2021

Abstract. Fetal fibroblast culture transplantation results were evaluated in the treatment of 18 burn victims. Comparison group consisted of 18 burn patients received medical care without cellular technologies utilization. The main comparison parameters in the study groups: the timing of the first stage of autodermoplasty; the number of autodermoplasties during the treatment; hospitalization duration; the newly formed epidermis area estimation. Fetal fibroblast culture transplantation in burn patients with extensive skin defects was performed on average 14,883,56 days after the injury. The timing of the first stage of autodermoplasty did not differ in the main and control groups, not exceeding an average of 19,122,01 days (p=0,48). An average of 2,710,67 surgeries using cell technologies performed in patients of the study group. The use of fetal fibroblasts culture in patients with extensive skin defects reduces the need for autodermoplasty by 1,6 times due to the granulation tissue formation and the epidermal growth beginning 7 days after and complete epidermal formation 14 days after transplantation. Regenerative medicine technologies utilization in patients with extensive skin lesions is possible and appropriate. Due to the fetal fibroblasts culture transplantation a kind of temporary biological coating is formed in the wound. It accelerates the wound healing process phase change from exudation to proliferation and the preparation of skin defects for autodermoplasty, expanding the possibilities of effective patients treatment.
Prognostic model of acute pancreatitis
Authors: Ivanusa S. Ya. , Lazutkin M. V. , Gal’chenko M. I. , CHebotar’ A. V. , Kulagin V. I.
Published: July 2021

Abstract. The models for the prognosis of infectious complications and the outcome of acute pancreatitis are developed based on a mathematical analysis of the totality of clinical and laboratory data on the course of the disease, which have the form of a decision tree. It was revealed that laboratory indicators show statistically significant intergroup differences and allow to form a prognosis of the course of the disease. The threshold values of laboratory parameters calculated as a result of applying the classification and regression algorithm by constructing a decision tree are the nodal points for the distribution of patients according to the likelihood of further development of the disease. Thus, the presence of an international normalized ratio of more than 1,31 or an international normalized ratio of more than 1,31 and a hematocrit of less than 40% with a predictive probability of 80% is associated with the development of infectious complications in any period of the disease in the first 3 days of the development of the disease. If in the first 3 days of the disease the glucose level exceeds 11,55 mmol / L and the concentration of Ca2+ ions is less than 0,66 mmol/L, the probability of death is more than 70%. If the glucose level is more than 11,5 mmol/L and the level of Ca2+ ions is less than or equal to 0,66 mmol / L, or the glucose level is less than or equal to 11,5 mmol/L and the prothrombin index is less than or 83% and the hematocrit is less than or equal to 39,8% the probability of developing a fatal outcome at any period of the disease is 3 times higher compared to other patients. Prediction models of infectious complications and disease outcome have an accuracy of 78 and 87%, respectively. The use of these models allows stratification of patients upon admission to the hospital, highlighting the most disadvantaged patients in the prognostic plan. The models are quite simple and easy to use, do not require complex expensive studies. Thanks to the algorithm used in building models, they have the properties of self-learning, which in the future will increase their accuracy.
The role of therapeutic nutrition and dietary supplements in the prevention and treatment of osteoarthritis at the initial stages of the disease in military personnel
Authors: Nagorny E. B. , Smetanin A. L. , Ishchyk Yu. V. , Korosteleva O. G. , Konovalova I. A. , Plakhotskaya Z. V.
Published: July 2021

Аbstract. Factors predisposing to the development of osteoarthritis in military personnel are analyzed. The physical stress inherent in military labor, for example, in the airborne troops, creates a high load on the joints and can cause the early dismissal of military personnel from the ranks of the Armed Forces of the Russian Federation. Based on the pharmacodynamics of chondroprotectors (stimulation of chondrocyte function, cartilage tissue regeneration processes, inhibition of the synthesis of inflammatory mediators, etc.), it can be argued that they have a significant effect on the pathogenetic mechanisms of the development of osteoarthritis, i.e. the mechanism of action of chondrocytes is reduced to the suppression of catabolic and stimulation of anabolic processes in the joints. The main principles of therapeutic nutrition for osteoarthritis are, a decrease in calorie intake, limiting the amount of carbohydrates, animal fats and salt consumed. A balanced diet, including sufficient macro- and micronutrients, has a therapeutic effect in patients with complaints of joint pain, helping to restore the damaged structure of the elements of the musculoskeletal system. The inclusion of dietary supplements in the diets of patients with complaints of joint diseases ensures the intake of nutrients necessary for the synthesis of glycosaminoglycans. These factors accelerate the rehabilitation of patients after extreme physical exertion and injuries of the musculoskeletal system inherent in military labor. An analysis of the materials of a clinical study a comparative study of the effectiveness of the treatment of osteoarthritis of the knee joint at the initial stage of the disease with the help of a representative of the group of chondroprotectors Аrthra containing chondroitin sulfate, glucosamine and non-steroidal anti-inflammatory drugs, is carried out. The introduction of chondroprotectors as a means of preventing osteoarthritis in the diets of military personnel experiencing extreme joint loads will strengthen the ligamentous-articular apparatus by normalizing cartilage moisture saturation, inhibiting the action of proteolytic enzymes and stimulating the synthesis of glucuronic acid, which improves the elasticity of connective tissue.
Features of the introduction of an information system for monitoring the movement of medicines in civil and military health care
Authors: Miroshnichenko Yu. V. , Shcherba M. P. , Merculov A. V. , Perelygin V. V.
Published: July 2021

Abstract. The features of the introduction of an information system for monitoring the movement of medicines in civil and military health care are considered. It has been shown that in order to counteract the inflow of substandard, falsified and counterfeit medicines to medical and pharmacy organizations, from July 1, 2020, all subjects of their circulation in the Russian Federation are required to enter the necessary information into the automated information system for monitoring the movement of medicines. The preliminary results of the experiment on labeling with control (identification) marks of medicines and monitoring of their circulation are evaluated. It is noted that the introduction of an automated information monitoring system in practice is associated with a number of problems that contribute, in particular, to an increase in the cost of medicines. It was established that in the formation of regulatory mechanisms for monitoring the movement of medicines,the specifics of drug provision in military health care were practically not taken into account, which in turn led to the emergence of a number of legal conflicts. It was revealed that, on the one hand, the obligations to participate in the medicine movement monitoring system have been lifted for the Ministry of Defense, the Federal Security Service, the Foreign Intelligence Service, and, on the other hand, other power ministries and departments must provide the required information to the system. It was emphasized that, given all the problematic issues, the introduction of an information monitoring system has a positive effect on the activities of drug circulation entities, as well as enhancing the effectiveness of drug provision for citizens. It is advisable to provide for separate participation in the information system for monitoring the movement of medicines of the Ministry of Defense and some other power ministries and departments, providing the opportunity, on equal terms with other participants, to confirm the quality of the medicines in circulation.
Genetic updating and marks of cellular lines
Authors: Moskalev A. V. , Gumilevskiy B. Yu. , Apchel A. V. , Tsygan V. N.
Published: July 2021

Abstract. Despite great advances in the biology of stem cells, there are still many dark spots. Genetic modification techniques, which can be used to track the lines of different cells, primarily stem cells, help to solve this problem. Various methods of biotechnology research are considered, allowing to evaluate the options of introducing new genes into cells and even whole organisms, as well as methods of controlling their expression in time and space, their activation, differentiation and decrease in functional activity, expression of several target genes. Options with multi-cystron vectors encoding several proteins are described. Options for introducing genes using plasmids, electroportation of their disadvantages and advantages are characterized. The most promising and the safest is a retroviral vector using lentivirus vectors capable of generating additional copies of itself, which is very important in the field of biotechnology security. A line of packing cells, usually 293T cells, is used to produce a viral vector. Prospects for the use of adenovirus and adenoassociated vectors are characterized. The achievement of modern biotechnology methods is the system of short palindrome repetitions located in groups, which is a unique tool for genome editing. At the heart of this system is the process of cutting out sequences of deoxyribonucleic acid, which are permanent and which are supported by cells regardless of subsequent divisions or changes in condition. The system allows geneticists and medical researchers to edit parts of the genome by removing, adding or modifying successive sites of deoxyribonucleic acid. An important problem with biotechnology methods is how to control the expression of transgenes. Today, it is quite effective to control expression with a factor present in the gene delivery vector itself and which is only active in a certain type of cell. Endonuclease bacteriophage P1 is used to regulate transgene expression, which cuts deoxyribonucleic acid only at specific sites. This system is introduced in both eukaryotic and prokaryotic systems.
Hemorrhagic fevers of viral nature. State of the problem and directions for creating effective means of prevention and treatment
Authors: Stepanov A. V. , Buzmakova A. L. , Potapova A. V. , Yudin M. A. , Apchel V. Ya.
Published: July 2021

Abstract. An attempt to summarize the data of available information materials on epidemiological aspects, the state and prospects of prevention and treatment of hemorrhagic fevers was. Hemorrhagic fevers of viral nature-zoonotic diseases caused by viruses containing ribonucleic acid are classified into 4 families: Arenaviridae, Bunyaviridae, Filoviridae and Flaviviridae. They are spread all over the world, and their pathogens are easily transmitted from person to person, thereby spreading quickly enough beyond the main focus of biological infection. That is why the causative agents of hemorrhagic fevers are regarded as highly contagious biological agents, and agents bioterrorism. Unfortunately, there are currently no effective means of specific prevention and treatment of these infections, and therapeutic measures are limited to the use of symptomatic means. In this regard, the search for substances with pronounced antiviral activity against pathogens of hemorrhagic fevers that can effectively protect against these infections, as well as prevent their occurrence and spread is one of the priority areas of research in modern Infectology, and with the involvement of modern achievements in the field of molecular Virology and genetic engineering. The data obtained in this regard allow a more in-depth understanding of the pathogenesis of hemorrhagic fevers, the mechanisms of interaction of the pathogen with the host at the cellular level, the mechanisms of intracellular replication of viruses, the formation of the hosts response to viral invasion and clinical manifestations of diseases.
Toxic effect of organophosphate compounds on the kidneys
Authors: Sokolova M. O. , Sobolev V. E. , Reshetkina D. A. , Nagibovich O. A.
Published: July 2021

Abstract. The study describes: the toxic effect of organophosphate intoxication compounds on the human and animal organism, the contribution of organophosphate to the chronic kidney disease epidemiology and the acute kidney poisoning pathophysiology caused by organophosphate compounds. The study shows oxidative stress and systemic hemodynamic disturbance in the pathogenesis of organophosphate-induced kidney injury. We summarized effects of organophosphate substances on the structural and functional kidneys tissue characteristics in humans and animals. Biomarkers useful for early diagnosis of kidneys toxic damage are shown. In study we considered microscopic and ultrastructural changes in the anatomical and histological kidney structures caused by acute and chronic organophosphate intoxication. The organophosphate compounds are highly toxic, easily overcome the epithelial integument, are able to penetrate cell membranes and the blood-brain barrier. These compounds are involved in the disruption of several key biological processes the acetylcholinesterase irreversible inhibition and the oxidative stress induction in the excretory organs cells. The kidneys are not the first target in the toxic effect of organophosphate compounds in the human body, but are actively involved in the pathological process. It was established that kidneys tissue damage by organophosphate compounds can manifest itself differently depending on the duration of exposure, type and concentration of the toxic compound. It was shown that the kidney injury pathogenesis during acute and chronic intoxication by organophosphate compounds remains not fully understood. Nephron dysfunction patterns depending from various doses and toxic agents exposure duration have not been identified.
In memory of Komarov Fyodor Ivanovich (on the occasion of his centenary)
Authors: Fisun A. Ya. , Yakovlev V. A. , Malov Yu. S.
Published: July 2021

Abstract. Fyodor Ivanovich Komarov (08/26/1920 01/25/2020) was a participant in the Great Patriotic War, a prominent domestic therapist, an outstanding figure in military medicine, a Hero of Socialist Labor, an academician of the Russian Academy of Sciences, a laureate of the State Prize of the Union of Soviet Socialist Republics, an honorary doctor of the S.M. Kirov Military Medical Academy, a professor and a retired colonel-general of the medical military service. F.I. Komarovs scientific heritage is huge. Over 600 scientific works, including 33 monographs, were published by him personally and in co-authorship. Due to his comprehensive clinical background and deep knowledge of physiology and biochemistry, urgent problems of gastroenterology, cardiology, pulmonology, chronobiorhythmology and military professional pathology could be successfully solved. He made a great contribution to improve and reform the military medical service. Twenty six doctors and sixty candidates of medical sciences were educated under his leadership. Being a military doctor and holding high leadership positions, he was constantly engaged in the improvement of military medicine and military field therapy. He was also the head of medical support for the troops during the hostilities in Afghanistan, during the accident at the Chernobyl nuclear power plant and following the consequences of the earthquake in Armenia. He was elected chairman of the All-Union Society of Physicians several times. He was also a member of the Lenin and State Prize Awarding Committee under the Council of Ministers of the Soviet Union, chairman of the expert council of the Supreme Attestation Commission of the Union of Soviet Socialist Republics and editor-in-chief of the journal Clinical Medicine and an honorary member of a number of foreign academies. In 1999, he was awarded the title Man of the XX century, became a laureate of four personal prizes: M.P. Konchalovsky (1979), S.P. Botkin (1985), N.I. Leporsky (1992), V. Kh. Vasilenko (2001). For his merits to the Fatherland, F.I. Komarov was awarded the title Hero of Socialist Labor (1980) in addition to forty five orders and medals.