Kirov Military Medical Academy Research Articles

Oleg Konstantinovich Bumay (in memory of a teacher, colleague, comrade)

January 1, 2024 marked the 70th anniversary of the birth of the former head of the organization and tactics of the medical service of the fleet (with a course of tactics and combat weapons of the fleet) department of the S.M. Kirov Military Medical Academy, effective director for modern topics of the Federal State Budgetary Institution Research Institute of Industrial and Marine Medicine FMBA of Russia, candidate of medical sciences, associate professor Oleg Konstantinovich Bumay (1954–2022). O.K. Bumay was born in the village of Bogudenka, Belarus. He was alumnus the faculty of training doctors for the Navy of the S.M. Kirov Military Medical Academy. After graduating from the academy in 1977, for a decade he provided and organized medical support for nuclear submarines as the head of the ship’s medical service, the cheef of medical a submarine forces in the Northern Fleet, and subsequently served as a senior medical officer in the Baltic Fleet. Over the course of two decades, O.K. Bumay was associated with the organization and tactics of the naval medical service (with a course of tactics and combat weapons of the fleet) department of S.M. Kirov Military Medical Academy. In 1991, he entered the adjunct program at the department; upon completion of his studies, he was appointed as a teacher, subsequently as a senior teacher, and since 2009 — deputy head of the department. He received the rank of Philosophy doctor of Medical Sciences (1994), associate professor (1998). After leaving the Armed Forces of the Russian Federation in 2007, he continued his career as deputy director for special topics at the Federal State Budgetary Institution Research Institute of Industrial and Marine Medicine of the Federal Medical and Biological Agency of Russia. O.K. Bumay developed origins medical support system for the domestic nuclear submarine fleet. Was appointed on the post the head of the ship’s medical service and after that officer of the command-and-control body of an operational-tactical formation. Throughout their career he left a multifaceted scientific and practical legacy, which is used by new generations of naval doctors.

The hypothermic effect of the antihypoxant 2-aminobenztiazole

BACKGROUND: One of the compounds studied at the Department of Pharmacology of the Kirov Military Medical Academy is a compound with a proven antihypoxic effect of 2-aminobenzothiazole (2-ABT). The mechanism of action of this substance is partially associated with the central action, and its protective effect may potentially be due to the general hypothermic effect.
 AIM: To determine the effect of 2-ABT on body temperature.
 MATERIALS AND METHODS: Experiments were carried out on 24 adult males of white outbred mice. 2-ABT was previously dissolved in 0.9% sodium chloride solution and administered intraperitoneally to mice at doses of 32.5 mg/kg (with proven antihypoxic effect), 21.7 mg/kg or 10.8 mg/kg. Rectal temperature was measured with an electronic thermometer DT-623 (China) before administration of the test substance, as well as 5, 30 and 60 minutes after the injection.RESULTS: Compound 2-ABT has a pronounced dose-dependent hypothermic effect. This effect is maximally expressed in a dose in which the compound has a proven antihypoxic property – 32.5 mg/kg. The hypothermic effect manifests itself within 5 minutes after administration, the maximum decrease in body temperature is observed after 30 minutes, while the effect persists for an hour.
 CONCLUSION: 2-ABT may be a promising compound for the creation of a drug for drug-induced (controlled) hypothermia.

Dedication to Morphology (to the 70th Anniversary of the Birth of Professor I.V. Gaivoronsky)

In February 2024, Professor Ivan Vasilyevich Gaivoronsky, Doctor of Sciences in Medicine, the prominent Russian morphologist, Head of the Department of Normal Anatomy at S.M. Kirov Military Medical Academy, celebrated the 70th anniversary. Ivan Vasilyevich was born on February 2, 1954 in the town of Kadievka, Voroshilovgrad region. In 1979, he graduated with a gold medal from S.M. Kirov Military Medical Academy; within its walls, he came a long way from an adjunct to the Head of the Department of Normal Anatomy, which he has headed for more than 35 years. Ivan V. Gavoronsky is a member of the Presidium of the All-Russian Scientific Medical Society of Anatomists, Histologists and Embryologists and Chairman of its St. Petersburg branch, a member of the Coordinating Council responsible for the field of education “Health and Medical Sciences” and its educational and methodological commission in anatomy and anthropology, Chairman of the dissertation council in the specialties Anatomy and Anthropology, Pathological Anatomy and Forensic Medicine, created at S.M. Kirov Military Medical Academy. Professor Ivan V. Gaivoronsky focused his attention on the development of modern aspects of the collateral circulation issues, the state of various parts of the vascular bed under normal conditions and under the influence of various extreme factors, innovative technologies for preparing and preserving anatomical sections for educational purposes, medical craniology, the study of individual and typological features of the human body, applied issues, dictated by the needs of practical medicine, the history of anatomy, and the improvement of the educational process in the departments of morphological profile. He created a scientific morphological school, which trained 11 doctors and 60 candidates of medical sciences. For significant contribution to the development of Russian science and modernization of the educational process, Professor IvanV. Gaivoronsky was twice awarded the Russian Government Prize in the field of education; he was awarded the honorary titles “Honored Scientist of the Russian Federation” and “Honored Figure of Russian Higher Education”, academician of the Russian Military Medical Academy, Honorary Doctor of the Russian Military Medical Academy; he was awarded the Order of Honor and a medal of the Order for Merits to the Fatherland, II degree.

Creator of the concept of antihypoxants and actoprotectors: On the occasion of the 100th anniversary of Professor V.M. Vinogradov

Vasiliy M. Vinogradov (1924–2003) and his scientific school are famous for their creation and study of two fundamental new classes of pharmacological drugs, promising for military medicine, medicine for disasters and extreme conditions, and for civilian healthcare. This refers to the development of antihypoxants, which are drugs that protect the body when there is a lack of oxygen in the cells or disturbances in its utilization, and actoprotectors (from the Latin “actus” — movement), which are drugs of a nondepleting type of action that increase and maintain the physical performance of the body in unfavorable conditions. At the Department of Pharmacology of the Military Medical Academy in the 1960s, F.Yu. Rachinsky synthesized the first highly effective antihypoxants structurally related to aliphatic and cyclic aminothiols — gutimin, amtizole, bemitil, almid, and etomerzole. Hypoxia is the most common, everyday factor in resuscitation practice; however, it is not the only factor causing energy deficiency with severe, often dramatic consequences for cells, organs, and the body as a whole. Therefore, when we talk about antihypoxants, we are referring to drugs that can smooth out this deficiency using various mechanisms, protect cells at the reversible stage of their damage, and activate the formation of structure and functions. These drugs were subjected to a detailed pharmacological study, and a key link in their mechanism of action was identified — normalization of energy metabolism when there is a lack of oxygen in cells or disturbances in their use. All aliphatic and cyclic aminothiols (gutimin, amtizole, bemitil, almid, etomerzol, and many of their analogs) have three main types of activity, which are expressed differently in each of the drugs, which makes it possible to profile their use in different clinical situations and in healthy people. These include (1) antihypoxic effects, (2) antioxidant effects, and (3) ability to accelerate the repair and adaptive synthesis of RNA, enzymes, and functional and structural proteins under various types of damage, such as hypoxic, infectious, toxic, and stress, and in adaptation to complicated conditions. All these directions were not only evaluated experimentally but also confirmed in practice. This article examines various aspects of antihypoxic drugs synthesized and studied at the Department of Pharmacology of the S.M. Kirov Military Medical Academy for the last 60 years.

Professor I.V. Gaivoronsky — an outstanding domestic scientist-anatomist and teacher

On February 2, 2024, the prominent Russian morphologist, head of the department of normal anatomy at the Kirov Military Medical Academy to MD, Dr. Sci. (Med.) Professor Ivan V. Gaivoronsky. Ivan V. was born in the town of Kadievka, Voroshilovgrad region, in 1954.
 On February 2, 2024, a prominent Russian morphologist, Professor Ivan V. Gaivoronsky became the head of the Department of Normal Anatomy at the Kirov Military Medical Academy to Doctor of Medical Sciences. Ivan V. was born in the town of Kadievka in the Voroshilovgrad region in 1954.
 In 1973, after graduating from the Starooskolsky Medical School, he entered the Kirov Military Medical Academy, from which he graduated in 1979 with a gold medal. He then studied in an adjunct course at the Department of Normal Anatomy. After completing his studies and defending his dissertation within the walls of his native alma mater, he worked his way up from a teacher to the head of one of the oldest departments, the Department of Normal Anatomy, which he has headed for 35 years. Professor I.V. Gaivoronsky pays great attention to solving modern scientific problems of morphology: collateral circulation, medical craniology, morphology of a gunshot wound, applied problems according to the needs of surgical practice, study of individual and typical characteristics of the human body, development of innovative technologies for the production and preservation of anatomical preparations for scientific and educational purposes, and improvement of the educational process in the departments of morphological profile and history of anatomy. He created a scientific morphological school, which trained 11 doctors and 63 medical science candidates. Professor I.V. Gaivoronsky is the author of polymer embalming technology, which has radically changed the principle of teaching fundamental medical disciplines. Thanks to the development of numerous innovative areas, numerous scientific studies, and use of the latest equipment in the educational process, the Department of Normal Anatomy of the Kirov Military Medical Academy, under the leadership of Professor I.V. Gaivoronsky, became one of the best methodological and scientific centers in the Russian Federation, dealing with the most pressing problems of modern morphology. For his great contribution to the development of domestic science and the organization of the educational process, Professor I.V. Gaivoronsky was twice awarded the Government of the Russian Federation Prize in the field of education. He was awarded the honorary titles “Honored Scientist of the Russian Federation” and “Honored Worker of the Higher School of the Russian Federation”, Academician of the Russian Military Medical Academy, and Honorary Doctor of the Kirov Military Medical Academy. He was also awarded the Order of Honor and the Medal of the Order for Services to the Fatherland, II degree.

Comparison of thrombodynamic tests with determination of anti-Xa activity in evaluation of the efficacy of anticoagulant therapy in patients suffering deep vein thrombosis of the lower extremities

Deep vein thrombosis of the lower extremities remains an important medical and social problem in practical medicine. Currently, a weight-dependent low-molecular-weight heparin dosing approach is used to treat deep vein thrombosis of the lower extremities in wounded patients without regard to the state of the hemostasis system. This observational study included 30 patients with deep vein thrombosis of the lower extremities who were hospitalized for examination and treatment at the Kirov Military Medical Academy. During treatment with enoxaparin sodium at therapeutic doses, depending on body weight, the parameters of the thrombodynamics test were assessed in all patients, and antiXa activity was determined at the peak of the drug (after 3–4 h) and at the end (before the next injection) of its action. A strong inverse correlation was established between the growth rate indicator of the thrombodynamics test clot and antiXa activity at the peak (–0.777; p 0.05) and at the end (–0.715; p 0.05) of the action of sodium enoxaparin. The standard dose of anticoagulant drug, depending on body weight, revealed that 30% of patients were in the hypercoagulation zone, not reaching the target values of the thrombodynamic clot growth rate and anti-Xa activity. The thrombodynamics test results identified the growth rate of the test clot with antiXa activity, which allows both methods to be considered comparable for laboratory monitoring low-molecular-weight heparin therapy in wounded individuals. The insufficient anticoagulant effect in one-third of the injured individuals that received the standard and therapeutic doses of low-molecular-weight heparins requires the development of a personalized approach to titration of low-molecular-weight heparins, which may be based not on the concentration of the drug per body weight but on the achieved anticoagulant effect that optimizes the treatment outcomes and patient prognosis. Accordingly, further research is required.

Relationship of professional success and development of cognitive mental processes and personal qualities of Vietnam Naval specialists

The levels of development of cognitive mental processes and personal qualities among specialists of the Navy of the Socialist Republic of Vietnam undergoing military service under a contract were considered, and their relationship with military-professional success was assessed. In July 2023, specialists from the Kirov Military Medical Academy together with Vietnamese specialists of the Russian–Vietnamese Tropical Center, conducted a pilot psychological and psychophysiological examination of naval specialists of the Navy of the Socialist Republic of Vietnam to study the characteristics of cognitive mental processes (attention, memory, and thinking), motivational and personal qualities, and expert assessments of the success of military-professional adaptation. Statistically significant relationships between expert assessments of professional success and the level of development of cognitive mental processes, characteristics of the motivational sphere, neuropsychic stability, and psychological adaptation characteristics have been identified. The results showed sufficient validity and reliability of the methodological apparatus used for assessing cognitive mental processes and personal psychological adaptive abilities in relation to assessing their relationship with the success of military-professional adaptation, an effective solution of professional and service tasks. The possibility and prospect of considering them in professional psychological selection and medical and psychological (psychophysiological) support of professional activities, examination, and, if necessary, subsequent medical and psychological rehabilitation of naval specialists of the Socialist Republic of Vietnam to maintain a high level of their professional health, as well as the need for further research.

Pathological changes of glial cells in the enteric nervous system of the colon with chronic slow-transit constipation

The origin, development and differentiation of enteric nervous system neuroglia and its involvement in the pathogenesis of gastrointestinal diseases and neurodegenerative diseases have been little studied.Aim of this work is a comparative morphological study of glial cells in the ganglionic plexuses of the enteric nervous system and analysis of neuroglial relationships in chronic slow-transit constipation using immunohistochemical methods.Material and methods. Resection material obtained at the Department of Faculty Surgery, S.P. Fedorov Faculty of Surgery of S.M. Kirov Military Medical Academy during planned surgical operations was used. The objects of the study were fragments of the sigmoid and colon obtained as a result of surgery for chronic slow-transit constipation (five cases, women aged 37–40 years). The study was carried out using immunohistochemical glial markers (GFAP, S100β protein, etc.).Results. Two types of glia were found in the myenteric ganglionic plexus of the large intestine: astrocyte-like and neurolemmocytic. The astrocyte-like type is similar to the neuroglia of the central nervous system, the neurolemmocytic type is similar to the glia of the autonomic nervous system. It has been established that astrocyte-like glia is found only in the Aauerbach ganglionic plexus, while neurolemmocytes are found in all innervated tissues of the intestinal wall. Reactive, dystrophic and degenerative changes in neurocytes, glial elements, agangliogenosis in the Auerbach plexus were found in all cases of chronic slow-transit constipation. Destructive changes in the neuromuscular terminal plexuses, interstitial edema and inflammatory monocytic reaction and leukocyte infiltration in the intestinal mucosa and intestinal submucosa, found in several cases.Conclusions. The results obtained allow classifying chronic slow-transit constipation as a neurodegenerative disease.

Professor Alexey Nikolaevich Kuchmin (on the 60th anniversary of his birth)

On July 27, 2023, Alexey Nikolaevich Kuchmin, the Head of the Department of Propaedeutics of Internal Diseases of the Military Medical Academy, named after S. M. Kirov
 doctor of Medical Sciences, Professor, and former chief therapist of the Ministry of Defense of the Russian Federation, turned 60 years old. A. N. Kuchmin was born on July 27, 1963, in Mineralnye Vody, Stavropol Territory. After graduation, he entered the Faculty of training doctors for the Navy of the Military Medical Academy named after S. M. Kirov, where he graduated with honors in 1986. For 4 years, he served as the Head of the medical center and the infirmary of the Baltic Fleet Naval Aviation. Since 1990, his life and fate have been inextricably linked with the Department of Propaedeutics of Internal Diseases of the Kirov Military Medical Academy, within the walls of which he has passed through a difficult but bright career path from a 3rd-year cadet to an associate Professor, from a teacher to a Professor and Head of the Department. Here, A. N. Kuchmin joined the scientific, pedagogical, and clinical ideas of Professor N. N. Savitsky. Having started his scientific activity under the guidance of Professor Yu. S. Malov, Alexey Nikolaevich devoted himself to the research of the most pressing issues of cardiology, pulmonology, and physiology. After graduating from the adjunct program in 1993 at the Department of Propaedeutics of Internal Diseases of the Academy, A. N. Kuchmin defended his PhD thesis on “The role of salivary glands in maintaining homeostasis in patients with hypertension”. Since that time, he has been a senior resident, then a teacher, associate Professor, and deputy Head of the Department of Propaedeutics of Internal Diseases (for clinical work) since 2005. In 2003, Alexey Nikolaevich defended his doctoral dissertation on cardiac arrhythmias in patients with bronchial asthma. His research interests now include issues in rapidly developing areas, such as endocrinology, ultrasound diagnostics, and functional diagnostics. During his work as the Chief therapist of the Ministry of Defense of the Russian Federation, A. N. Kuchmin proved himself to be a competent Head of the therapeutic service of the Ministry of Defense of the Russian Federation, particularly during the armed conflict in Abkhazia and Georgia. A. N. Kuchmin’s talent as a clinician and organizer of clinical and expert work was also manifested in his leadership from November 2008 to 2010 in the Department of Therapy of the State Institute of Advanced Training of Doctors of the Ministry of Defense of the Russian Federation and since 2015 in his native Department of Propaedeutics of Internal Diseases of the Military Medical Academy named after S. M. Kirov. In all his positions, Alexey Nikolaevich was and remains a highly professional specialist in his field with several clinical interests and knowledge.

The method for assessing the severity and monitoring the effectiveness of treatment neuropathic pain syndrome

The existing difficulties in objectifying the patient’s complaints about the severity of the pain syndrome create the need to create new practical tools for assessing its intensity, as well as monitoring the effectiveness of treatment. Based on the accumulated experience of providing care to patients with neuropathic pain syndrome of traumatic genesis, the staff of the M.I. Astvatsaturov Clinic of Nervous Diseases of the Kirov Military Medical Academy has developed a method for assessing the severity and monitoring the effectiveness of treatment of neuropathic pain syndrome. The method is based on the patient’s auto-monitoring of his pain sensations during one day with the sequential fixation of the average hourly indicator of the severity of the pain experienced on an 11-point digital rating scale, as well as indicating the duration and quality of sleep in a daily graphic pain diary. The doctor evaluates the average daily and total daily pain indicators, as well as sleep parameters. The developed method has high visibility and reproducibility, has been tested, implemented and is used at the Kirov Military Medical Academy in the treatment of patients with neuropathic pain syndrome.

THE EXPOSITION OF THE GREAT FATHERLAND WAR GUNSHOT WOUNDS ANATOMICAL PREPARATIONS AS A LEARNING AND MATERIAL BASE FOR MILITARY DOCTORS TRAINING

In the initial period of the Great fatherland war, one of the reasons for significant sanitary losses was the insufficient staffing of army units with experienced military medical specialists. Civilian doctors urgently mobilized in the first days of the war did not have sufficient knowledge in the field of military field surgery. There was a need to generalize the experience acquired by military doctors when providing assistance at the stages of medical evacuation, as well as by military field surgeons who performed surgical interventions in medical battalions and hospitals. To study the morphology of gunshot wounds of various parts of the body and organs, it was necessary to create an equipped educational and material base, including preparations with wounds of almost all parts of the body and organs. To study them, by order of the main military sanitary department of the army, mobile pathological anatomical laboratories were created, whose employees collected and documented a large collection of pathological anatomical preparations, which were transferred to the Military Medical Museum in St. Petersburg. After the end of the war, for several decades, a significant part of the exhibits lost their demonstration qualities, and some exhibits fell into disrepair. In 1988, thanks to the efforts of Professor Ivan Guyvoronsky, these exhibits were transferred to the Department of Normal Anatomy of the Kirov Military Medical Academy, where under the guidance of Professor Pavel Pashchenko were restored using a specially developed method. The essence of the method consisted in several sequential stages of drug recovery. At the first stage, mechanical manual cleaning of the preparations from mold was carried out, removing decayed and torn fragments and giving it the proper form for display. At the next stage, thorough washing was carried out, followed by bleaching of the preparations in solutions of hydrogen peroxide of various concentrations and special solutions. By 1990, a special “Exhibition of gunshot wounds” was created, which is part of the fundamental anatomical museum of the department. Currently, the materials from this exhibition are used as unique visual material in the process of training and educating military doctors.

Morphological features of basal laminas of enteral nervous system structures in chronic slow transit constipation

BACKGROUND: Studies on basal laminas in the tissues of the enteric nervous system are few and are carried out on experimental models in vivo and in vitro, performed on animals. The morphological features of the structure and localization of BL, their cellular sources of origin in various tissues of the gastrointestinal tract in normal and pathological conditions remain poorly studied.
 AIM: Study of morphological features and distribution of basal laminas in human colon tissues and their changes in pathology.
 MATERIALS AND METHODS: Fragments of the large intestine, obtained as a result of surgery for chronic slow-transit constipation, performed in S. M. Kirov Military Medical Academy were studied. The selective marker of basal laminas, type IV collagen, as well as neuronal and glial immunohistochemical markers (PGP 9.5, GFAP, S100 proteins) were used in the work
 RESULTS: It has been shown that the greatest immunoreactivity within the intestinal wall is observed in the myenteric membrane, weak in the vessels of the submucosa, locally expressed in the subepithelial region of the mucous membrane (in the upper sections of the crypts). In smooth muscle, basal laminas were found around the smooth muscle cells of the longitudinal and concentric layers of the muscular membrane, mucous membrane, veins and arteries, as well as in the endothelium. It has been shown that the ganglionic Auerbachs plexus is delimited from closely adjacent muscle layers of a continuous basal lamina, similar to the basal plate (glia limitans) of the brain and spinal cord of the CNS. It is clearly defined by its appearance it has the form of a continuous hollow tubular structure. The sources of the formation of the basal plate around the ganglia of Auerbach and Meissners plexuses are various glial elements: in the first plexus, astrocyte-like and non-myelinated Schwann cells (both types located in the neuropil), and in the second plexus, glia of the autonomic nervous system (satellite cells of neurons and neurolemmocytes of postganglionic nerve fibers).
 CONCLUSIONS: For the first time, the transition of basal lamina from the Auerbachs plexus to numerous basal plates of neurolemmocytes of the Remakov fibers of the main terminal nerve plexus, which are involved in the innervation of the smooth muscle cells of the muscular membrane, is shown. Signs of dystrophic changes in the basal lamina structure associated with pathological changes in chronic slow transit constipation (tissue edema, inflammatory reactions, manifestations of agangliosis, gliosis, focal denervation of muscle cells, degeneration of nerve endings of neuromuscular and ganglionic plexuses) are shown in the work.

Экспериментальное исследование биодеградации синтетических полимерных матриц как перспективных подложек для лимбальных стволовых клеток

Aim. To study in experimental conditions and conduct a comparative assessment of the terms of biodegradation of three different types of synthetic polyester matrices as promising carriers of limbal stem cells. Material and methods. We performed matrices from poly(lactide-glycolide) (PLG), poly(lactide-caprolactone) (PLC) and poly(ε-caprolactone) (PCL). On the basis of the S.M. Kirov Military Medical Academy (St. Petersburg) estimated the timing of the biodegradation of matrices from the PLG, PLC and PCL with a thickness of 5; 10 and 15 microns by binding in vitro to the ocular surface of laboratory animals. Results. During the study, the terms of biodegradation of matrices from PLG, PLC and PCL of various thickness were studied. The time of complete biodegradation of PCL matrices with a thickness of 5 μm was about 30 days, which is the most acceptable for the purpose of their transplantation to the eye surface. Conclusion. The obtained results indicate the possibility of using PLC as a material for the manufacture of matrix carriers with a thickness of 5 μm for the cultivation and transplantation of limbal stem cells. Keywords: poly (lactide-glycolide), poly (lactide-caprolactone), poly (ε-caprolactone), biodegradation, limbal stem cells.

The organization of medical equipment provision to the armed forces of the russian federation in the first decade of the 21st century

ABSTRACT. This article presents the activities of the medical service in organizing the provision of medical equipment to the troops (forces) of the Russian Federation in the first decade of the 21st century. It reflects the main stages of development of the pharmaceutical industry in the post-default state of the economy and the emergence of new mechanisms and forms of interaction with transnational pharmaceutical companies. The article showcases the positive features and shortcomings of implementing programs for additional drug provision and ensuring the population has access to necessary drugs. Additionally, it discusses the reorganization of the medical service of the Armed Forces of the Russian Federation as part of a large-scale reform of the military organization. The organizational and staffing changes in the military administration of the medical service, pharmaceutical organizations of the Ministry of Defense of the Russian Federation, and medical supply units are represented, highlighting their reorganization and restructuring by the end of the 2000s during the ongoing modernization of the Russian Federation Armed Forces. The article also describes the three-level system of medical supply of troops (forces) that developed after modernization. The leading role of the Department of Military Medical Supply and Pharmacy of the Kirov Military Medical Aca demy and the Center for Pharmacy and Medical Equipment in updating the regulatory legal framework for the medical supply system for troops (forces) is discussed. Their activities of these entities during the modernization of the medical supply system for troops (forces) to create key regulatory legal acts such as orders and directives of the Minister of Defense of the Russian Federation and official documents as part of research work are disclosed. Finally, the article provides a list of normative legal acts and service documents developed during this period, which regulate various aspects of activities related to providing military equipment to the troops (forces) and have been updated and harmonized with the legislation of the Russian Federation, is given.

Experience with augmented reality technology in the surgical treatment of a patient with encapsulated metal foreign bodies of lower extremities

ABSTRACT. This paper presents the experience of using augmented reality (AR) technology in the surgical treatment of a patient with encapsulated foreign bodies in the lower extremities. The study aims to test a previously developed algorithm for implementing AR technology in surgery and assess its effectiveness in treating patients with encapsulated foreign bodies. The study was conducted by a multidisciplinary team, comprising the Department of Naval Surgery of the S.M. Kirov Military Medical Academy and the Technical University named after Peter the Great. The medical and technical aspects involved an AR hardware and software package, including a personal computer and Microsoft Hololens II AR glasses. An invasive fixation system was also developed, incorporating a threaded pin used as an X-ray contrast mark with a seat for attaching special markers. The clinical part of the study involved observing and subsequently removing encapsulated foreign bodies in a patient who received inpatient treatment at the clinic of the Department of Naval Surgery in October 2022. Overall, AR technology demonstrated the potential for performing minimally invasive removal of encapsulated foreign bodies in limbs. The detailed visualization provided by AR allowed for determining optimal operative access, the volume of the upcoming operation, and the exact position, skeletotopy, and syntopia of the foreign body during the preoperative stage. Consequently, various intervention options could be digitally simulated. The use of AR technology facilitated intraoperative navigation, enhancing the safety and efficiency of the operation. Thus, AR technology has proven to be a minimally invasive, safe, and effective tool in surgical treatment. However, several unresolved issues require further research.

Микробиоценоз кожи у военнослужащих с абсцедирующим фурункулом челюстно-лицевой области

INTRODUCTION: Among non-odontogenic inflammatory diseases of the maxillofacial region, most common are abscessed furuncles. The causative agent of the disease is S. aureus (95%) mostly occurring as a monoculture. AIM: To study the microbial flora of facial skin in military personnel with abscessed furuncle of the maxillofacial region. MATERIALS AND METHODS: In 53 patients with abscessed facial furuncles (the main group) aged from 18 to 25 years, material was taken for bacteriological examination from healthy areas of the skin and from the furuncle with a sterile cotton swab. As a comparison group, a group of 30 practically healthy individuals of the same age was recruited, who also underwent a microbiological examination of facial skin areas. Examinations were performed in the bacteriological laboratory of Kirov Military Medical Academy. RESULTS: Among the representatives of the microflora of healthy skin areas in patients with abscessed furuncles of the face, S. epidermidis was detected in 58% of cases, S. saprophyticus in 33%, S. haemoliticus in 10%. In 30% of admitted patients, Propionibacterium acnes were found. In 4% of cases, S. aureus was detected by us. Fungi of the genus Candida were found in 5% of patients. The microbial composition of the wound discharge in facial furunculosis in 87% of cases was represented by pathogenic S. aureus as a monoculture, in 4% in association with S. saprophyiticus, in 3% with Pseudomonas aeruginoza, in 1% in association with Klebsiella oxytoca, in 5% by S. epidermidis as a monoculture. The species composition of the microflora of the facial skin of healthy people was represented by non-pathogenic staphylococci S. epidermidis (88.1%), S. saprophyticus (40%). In 25.3% of cases, streptococci were also detected. In 10% of cases, yeast-like fungi of Malassezia genus and in 12% of Candida genus were found. In 4% of cases, the pathogenic form of S. aureus was identified. CONCLUSION: The revealed differences in the composition of microorganisms of healthy skin areas between healthy individuals and patients with abscessed facial furuncles permitted to suggest the presence of dysbacteriosis of skin of the maxillofacial region in patients with abscessed furuncles, which led to the development of the disease.

Evaluation of the psychometric qualities of methods for identifying signs of deviant behavior in military personnel

AIM: To assess the psychometric qualities of the methodology for identifying signs of deviant behavior in military personnel developed at the S.M. Kirov Military Medical Academy.
 MATERIALS AND METHODS: The ISADA method is a screening questionnaire for assessing the presence of a propensity for deviant forms of behavior in military personnel. The questionnaire was developed at the S.M. Kirov Military Medical Academy. The abbreviation ISADA was used as a name for the methodology, consisting of the names of its main scales Avoidance, Suicidality, Aggressiveness, Delinquency and Addictiveness. The questionnaire consists of 60 questions directly related to well-being, behavior or character, to which the subject must answer only yes or no. Also, the Dynamic Observation Questionnaire and the Questionnaire for Evaluating the Professionally Important Qualities of a Serviceman were used to determine the success of the military professional activities of servicemen.
 RESULTS: According to the results of the assessment of the psychometric qualities of the technique for identifying signs of deviant behavior in military personnel, the majority (from 75 to 95%) did not reveal a tendency to deviant (deviant) forms of behavior. The scales of the ISADA questionnaire generally comply with the requirements of the Guidelines for the development, examination, implementation and use of professional psychological selection methods in the Armed Forces of the Russian Federation.
 CONCLUSION: The ISADA method has a high social significance, since its application will allow diagnosing the propensity of military personnel to deviant (deviant) forms of behavior. This technique can be recommended for use. In the course of the practical use of the ISADA methodology, it is advisable to continue work on assessing its predictive validity.

Biological and functional properties of human umbilical cord-derived lyophilized tissue-engineered matrices

The use of tissue-engineered products (TEP) from decellularized extracellular matrix (dECM) to treat deep skin lesions is a tissue engineering method that promotes regenerative healing. Cell-free preparations reproduce the hierarchical complexity of tissues, mimic structural, biochemical and mechanical signals that are necessary to attract cells, and are a source of bioactive molecules. The human umbilical cord biomaterial has a fetal phenotype with extra-embryonic origin, and therefore is available and has no ethical limitations in its use. The tissue engineering laboratory at Kirov Military Medical Academy developed and patented a TEP from the highly regenerative human umbilical cord in the form of matrix and hydrogel matrix. To study its regenerative potential, lyophilisates of tissue-engineered solid-state and hydrogel matrices were implanted around mini pig fullthickness wounds in vivo. The external signs of inflammatory response and the histological images of biopsy specimens from the lyophilizate implantation areas were analyzed. The effect of nutrient media, «conditioned» with lyophilizates of both matrices, on the viability and migration activity of fibroblast-like cells, isolated from mini pig skin, was investigated. The matrix lyophilisates showed good biocompatibility and bioactivity in in vitro and in vivo experiments. Implantation of the samples promoted faster formation of mature epidermis compared to the control.

Effects of fullerene C60 with antihypoxants

BACKGROUND: Drug improvement is often carried out with the help of chemical modifications that improve the receptor action or transport of drugs to their target tissues.
 AIM: The aim of this study was to investigate the effect of combinations of C60 fullerene with amtizol, 2-amino-4-acetylthiazolo[5,4-b]indole, metaprot, metaprot base, and rutin on antihypoxic activities in a model of acute hypoxia with hypercapnia.
 MATERIALS AND METHODS: Several compounds with mono-, bi-, and tricyclic structures were examined separately or combined with C60 fullerene. All compounds, except for rutin, were synthesized at the Department of Pharmacology of the S.M. Kirov Military Medical Academy and contain active amino groups, nitrogen, and sulfur atoms in the cycles: amtizol (3,5-diamino-1,2,4-thiadiazole), VM-606 (2-amino-4-acetylthiazolo[5,4-b]indole), Metaprot (2-ethylthiobenzimidazole hydrobromide monohydrate), and Metaprot base. All compounds demonstrated antihypoxic activity. Hypobaric hypoxia was simulated in a flow pressure chamber by lifting animals to a height of 10,000 m at a speed of 50 m/s and exposure for 60 min. The preparations were administered intraperitoneally 60 min before the experiment. The protective effect was evaluated by the average life expectancy at altitude. Hypoxia with hypercapnia was assessed on male white mice weighing 2022 g, which were placed in 200 mL glass jars with hermetic lids, which were lowered under water to prevent air leakage. The studied preparations and their complexes with fullerene in the form of a thin suspension with Tween-80 were administered intraperitoneally min before hypoxia. The lifespan of the animals was recorded.
 RESULTS: The formation of the complex and its properties depend on the development of a donoracceptor bond between the drug and fullerene. An increase in the bioavailability of amtizol in the form of a complex with C60 fullerene increased the antihypoxic activity of the mixture by 40%. For the first time, dynamic curves of the activities of amtizol and 2-amino-4-acetylthiazolo[5,4-b]indole depending on time were obtained in a model of hypercapnic hypoxia.
 CONCLUSION: Fullerene C60 enhances the antihypoxic activity of the studied compounds due to an increase in the bioavailability of the antihypoxant caused by the microporation of tissue membranes due to the action of fullerene C60.

The problem of open and tension pneumothorax at the prehospital stage of emergency care and prospects for its solution

The purpose of the study is experimental testing of Russian medical devices for the elimination of tension and open pneumothorax.Objectives of the research. Perform an analysis of the volume of therapeutic measures in the wounded and injured with open and tension pneumothorax. Conduct experimental testing of Russian samples to eliminate tension and open pneumothorax.Materials and methods. A retrospective analysis of the medical histories of 232 patients with polytrauma admitted for treatment at the war surgery department of the Kirov Military Medical Academy in the period from 2015 to 2019. An experimental study was carried out on large biological objects (pigs) to evaluate the effectiveness of eliminating open and tension pneumothorax using products from the UD-02f (paramedic) kit.Results. A retrospective analysis of the medical histories of 232 patients with polytrauma admitted for treatment at the clinic in the period from 2015 to 2019 was carried out. The incidence of tension pneumothorax was 11.6%. In 44.4% of cases, it was eliminated; in 55.6% of the ambulance teams, tension pneumothorax was not eliminated. Open pneumothorax was diagnosed in 21.1% of those admitted at the prehospital stage. In all cases, the elimination of open pneumothorax was carried out by applying an improvised sealing bandage to the chest. An experimental study of the effectiveness of the UD-02f set showed that the use of products included in this set allows to effectively eliminate the life-threatening consequences of wounds and chest injuries.Conclusion. Open and tension pneumothorax are severe life-threatening consequences of chest injuries with a development rate of up to 12.1% and 11.6%, respectively. The inclusion of a set for eliminating tension and open pneumothorax disposable, sterile (paramedical) UD-02f, in the complete equipment and training of medical personnel in the procedure for its use, will allow timely and effective elimination of tension or open pneumothorax at the prehospital stage of emergency medical care.