Medical Academy Research Articles

Limitations of CDX and PDX methods using for cultivation of malignant ovarian neoplasms and their mathematical justification

The article presents information on the most popular methods of culturing human malignant neoplasms to implement the obtained fundamental knowledge into the basis of translational research in oncology. A brief description of each of them allows you to decide on the possibility of including the technique in experimental work. The first approximation to the formation of the logic of the mathematical justification of the design of an experiment on modeling human malignant neoplasms is given.Also, using the example of a brief description of the original design of the experiment of scientists from the Khanty-Mansiysk State Medical Academy and the Tyumen State Medical University, the logic of constructing the design of such an experiment as part of the research work is demonstrated. An idea is formed about the need to include fundamental and translational stages in clinical experimental work as part of a unified strategy for responding to the great challenges of personalized medicine. An idea is formed about the need to include fundamental and translational stages in clinical experimental work as part of a unified strategy for responding to the great challenges of personalized medicine.

Moisei Schwartz: A military surgeon, educator, and researcher

The personnel of the Department of Dentistry (after 1942, the Department of Maxillofacial Surgery and Dentistry) of the Military Medical Academy named after S.M. Kirov made major contributions to the advancement of dentistry and maxillofacial surgery in Russia. This essay focuses on the professional life of Associate Professor Moisei Schwartz, Major of the Medical Service, whose research significantly contributed to experimental dentistry and periodontology. The essay uses the data presented in Russian literature on dentistry and maxillofacial surgery, as well as the recollections of dentists who knew Moisei Schwartz personally: V.P. Zabelin, Colonel of the Medical Service, and Associate Professor V.V. Fiolkovsky, Colonel of the Medical Service. Associate Professor Moisei Schwartz, Major of the Medical Service, performed several studies of the functional properties of jaw vessels, primarily mandibular vessels. He was the first to use the Kravkov–Pisemsky technique in dentistry to assess the effect of biogenic amines on isolated jaw vessels. His comparative studies of ear and jaw vessels in dogs using this technique revealed that jaw vessels are hypersensitive to acetylcholine, histamine, and adrenaline. In 1936, Moisei Schwartz developed an experimental periodontitis model using chronic irritation (ligation) of the inferior alveolar nerve in dogs. Moisei Schwartz fought in the Soviet-Finnish War of 1939–1940, as well as the World War II (1941–1945). Moisei Schwartz was a prominent scientist and experienced doctor with good manual skills, including surgical care in maxillofacial wounds. Moreover, he was a passionate researcher and educator. His contributions to experimental dentistry and periodontology are impossible to exaggerate.

Aleksander F. Tur — outstanding pediatrician, scientist, teacher (on the 130th anniversary of birth)

In 2024, the medical community will celebrate the 130th anniversary of the birth of the outstanding pediatrician, scientist, creator of scientific and practical schools of pediatrics — Alexander F. Tur. Alexander F. Tur was born on September 3 (15), 1894. In 1911 he was enrolled in the Imperial Military Medical Academy. From April 1915 he worked as a doctor in the active army; in August of the same year, A.F. Tur was captured and worked as a doctor in the infirmary for 3 years. In 1918, A.F. Tur resumed his studies at the Academy. From 1921 to 1930 — he worked part-time in the clinic of childhood diseases of the Military Medical Academy, under the guidance of Professor M.S. Maslov, in 1925 he was enrolled in the staff of the Leningrad Scientific and Practical Institute of Maternity and Infancy Protection named after Clara Zetkin. In 1939, the Department of Hospital Pediatrics was organized at the institute, headed by Alexander F. Tur and worked there until the end of his life. During the war years, A.F. Tur supervised the organization of clinic bomb shelters, advised children, conducted rounds, lectured students, and gave lectures to residents of the besieged city. A.F. Tur worked on a wide range of scientific problems in pediatrics, devoting his work to the most pressing issues of medicine: physiological characteristics and education of healthy children, physiology and pathology of newborns and premature babies, hematology of a healthy and sick child, dietetics of a healthy and sick child, rickets in children and its prevention, organization of children’s healthcare. A.F. Tur laid the foundations of preventive medicine at the outpatient stage, which are still followed today. The legacy of scientist is a fundamental pediatric school, a large number of scientific discoveries and works, thousands of trained do.

“The doctors guide to the correct examination of dead human bodies...” by I.V. Buyalsky (1824): the first original Russian guide to forensic medical examination

The year 2024 marks the 235th anniversary of the birth of Ilya Vasilyevich Buyalsky, an outstanding Russian surgeon, anatomist, and forensic physician and Honored Professor of the Imperial Medical and Surgical Academy and academician of the Imperial Academy of Arts. Another anniversary date of this year is associated with Buyalsky’s name: exactly 200 years ago, “The doctors guide to the correct examination of dead human bodies for finding the cause of death, especially in forensic cases,” which was the first original domestic manual on forensic medical examination, was published in the Military Medical Journal. This article comprehensively examined the history of the creation of this work, its main points, and its significance for subsequent generations of Russian forensic medical experts. The article provides information about the activities of Buyalsky in the field of forensic medical examination. An analysis of his work “The doctors guide to the correct examination of dead human bodies...” is presented. The present study shows that Buyalsky was one of the founders of forensic thanatology in our country, and the main provisions of “The doctors guide to the correct examination of dead human bodies...” remain relevant to date.

The impact of rehabilitation on the recovery of executive functions in stroke patients with different location of the ischemic focus.

Cognitive dysfunction is part of the clinical picture of stroke. Most of the executive dysfunctions are diagnosed in the early stage of rehabilitation, a few weeks after the vascular incident. Coexistence of executive dysfunctions with other disorders in stroke patients may hinder patient's functions, slow down the rehabilitation process, and disrupt self-awareness, interpersonal communication, and professional activity in everyday life. Ninety patients after ischemic stroke were examined (right hemisphere stroke: N = 33, left hemisphere stroke: N = 57). The study group (N = 45) consisted of patients rehabilitated in the Department of Rehabilitation and Physical Medicine of the University Teaching Hospital of the Military Medical Academy in Lodz, Łódź, Poland, in whom a comprehensive neurorehabilitation program was implemented, consisting of motor and neuropsychological rehabilitation. The control group (N = 45) consisted of patients awaiting admission to the department, who were covered by comprehensive environmental rehabilitation including exercise therapy and neuropsychological therapy. Executive function was measured with 3 popular diagnostic tools: the Wisconsin Card Sorting Test (WCST), the Trail Making Test (TMT part A, TMT part B), and the letter test and category test with the Verbal Fluency Test (VFT). The tests were carried out twice: the first time before the start of rehabilitation and 5 weeks later after its completion. Although patients with right-hemispheric stroke showed better improvement in executive functions, stroke location did not prove to have significant impact on how effective the rehabilitation was. Right hemisphere stroke patients showed greater improvement in restoring executive functions after rehabilitation compared to left hemisphere stroke patients. The location of the stroke did not significantly correlate with the efficiency of the rehabilitation setting. Int J Occup Med Environ Health. 2024;37(4):452-67.

Dmitry S. Gorbachev – the path of a military doctor

The name of Dmitry S. Gorbachev has a worthy place in the list of teachers and ophthalmic surgeons of the Department of Ophthalmology of the Kirov Military Medical Academy and military ophthalmology in general.D.S. Gorbachev dedicated his life to military medicine, training and education of future military doctors. He is a student of Professor V.V. Volkov, and was deeply immersed in the complex problem of orbital surgery. At the Department, D.S. Gorbachev, due to his deep scientific immersion in the problem, brought the field of orbital surgery to a modern multidisciplinary level. He constantly passed on his knowledge and skills to his students, who are currently continuing his work.

Eduard-Anton Ya. Krassovsky (on the 125th anniversary of his death)

This article is dedicated to the 125th anniversary of the death of Anton Ya. Krassovsky, who was one of the greatest obstetricians of the 19th century, the founder of scientific obstetrics and operative gynecology in Russia, public figure, professor and academician of Imperial Medical and Surgical Academy. The paper highlights his biography, scientific, teaching and social activities. A.Ya. Krassovsky’s enormous contribution to the development of operative and scientific obstetrics and gynecology, as well as improvement of gynecological operations is highly noted in the article. Particularly noteworthy is the participation of Prof. A.Ya. Krassovsky in the foundation of the first Saint Petersburg Obstetrics and Gynecology Society in Russia, in the training of doctors and midwives, and in the creation of the first domestic school of obstetricians and gynecologists and the first scientific journal in Russia for obstetricians and gynecologists. The “Journal of Obstetrics and Women’s Diseases” laid down the basic ideas and directions that contributed to the formation and development of domestic obstetrics and gynecology.

THE POTENTIAL OF DIGITAL TECHNOLOGIES IN IMPROVING THE PROCESS OF TRAINING AND RETRAINING OF MILITARY DOCTORS

The issue of improving the process of training and retraining of military doctors is determined by changes in the security environment of the state today, and the need to develop the military medical sector in the conditions of long-term resistance to russian aggression. This article highlights the potential of using digital technologies to improve the process of training and retraining of military doctors. The results of a survey of trainees at the Ukrainian Military Medical Academy (a higher military medical educational institution that provides training, retraining and advanced training of specialists in almost all specialties for the Armed Forces of Ukraine and other military establishment of Ukraine) are presented. It is shown that for the implementation of changes in the system of training and retraining of military doctors the Academy provides for a number of measures: introducing innovative changes in the content and methodology of education; introduction of flexible technology for planning and organizing the educational process, focused on personalization of learning; development of international scientific and scientific-medical collaborations. Based on the conducted research, it was determined that in the conditions of active hostilities in Ukraine, it is digital technologies that make it possible to quickly introduce changes in the process of training and retraining of military doctors by improving the educational and informational environment. It was established that improving the readiness of military doctors to use digital technologies in their professional activities requires their end-to-end use in the entire training system. The article provides examples of the use of digital technologies in the process of training and retraining of military doctors.

Оказание хирургической помощи пострадавшим от применения огнестрельного оружия ограниченного поражения в Арктической зоне Архангельской области

Summary. The aim of the study was to estimate the surgical care provided to the victims of traumatic weapons in the Arctic zone of the Arkhangelsk region. Materials and methods of research. We conducted a document-based statistical study using the records from 248 case histories (statistical form # 003/u) filled in for the victims of traumatic weapons, who received medical care in medical facilities of Arkhangelsk and Severodvinsk cities, located the Arctic Zone of Russia in 2005-2022. The research methods are analytical and mathematical-statistical. Categorical variables presented as percentages and frequencies were used for the analysis. The values of all relative quantities were calculated using the WinPepi program. The severity of the injuries was assessed using the VPKh-P(OR) scale, developed under the supervision of Major General of the Medical Service, Professor E.K.Gumanenko (1990) at the S.M.Kirov Military Medical Academy. The results of the study and their analysis. Every third victim of limited-damage firearms in the Arctic zone of the Arkhangelsk region required inpatient surgical care with the involvement of surgeons of various specialties. In case of multiple and combined wounds, it was necessary to involve two or more surgeons of various profiles. In case of minor wounds from limited-damage firearms during primary surgical treatment, the severity of the wound is underestimated by surgeons and, as a result, the bullet is not initially detected and remains in the wound, which, in turn, complicates the condition of the victim and requires repeated surgical intervention. In 39% of cases of wounds from limited-damage firearms to the head, every fifth case (21.9%) of wounds to the chest, every tenth case of wounds to the abdomen – specialized surgical care is required, the availability of which in the Arctic zone can be very problematic.

Defence Services Medical Academy (DSMA): A comprehensive overview of its educational framework and contributions to medical education

Defence Services Medical Academy (DSMA): A comprehensive overview of its educational framework and contributions to medical education

Correlation of perfusion index change and analgesic efficacy in transforaminal steroid injection for lumbosacral pain, a prospective observational study.

Low back pain is a common problem and a major burden to society. Transforaminal epidural steroid injection is one of the most effective treatment modalities for back pain. We aim to objectively quantify pain relief of lumbosacral radicular pain post transforaminal steroid injection by correlating perfusion index (PI), reflecting real-time peripheral blood flow change at the site of monitoring, controlled by sympathetic system with Numerical rate score (NRS) and SLRT improvement. A prospective observational study, conducted at K.S Hegde Medical Academy, Mangaluru, from June 2021 to June 2022 as a time-bound study. After IEC clearance (IEC certificate number) for the procedure and study, patients undergoing transforaminal epidural steroid injection for lumbosacral radicular pain were enrolled, excluding those meeting the exclusion criteria. PI change and NRS score improvement were noted at 0, 5, 10, 15, and 30 minutes along with pre and post-procedure SLRT. Results were analyzed. A total of 40 patients were analyzed. PI change at 30 minutes was 2.113 from a baseline of 0.217. Median NRS of 5, improved to 0 and the mean SLRT of 45.17 to 61.45 at the end of 30 minutes. All changes are statistically significant with P (<0.01). correlation between the PI change with NRS is mild (-0.312). PI change ratio shows an overall improvement in pain levels objectively, in a non-invasive, easy, and reliable way. Simultaneous improvement in both NRS and SLRT is clinically significant but cannot predict a correlated quantitative measure of pain relief.

Сезонные изменения качества сна студентов как предикторы «адаптационной» инсомнии

Background: Sleep disorders occur even at a young age and may result from environmental factors such as circannual fluctuations in hormonal background and social sleep restriction, leading to the development of insomnia. The aim of the study: To assess the quality of sleep in young people (medical students), living in the city of Vladikavkaz in the spring and autumn seasons of the year for identifying predictors of insomnia. Materials and methods: With the help of the Pittsburgh questionnaire to determine the indices of sleep quality, we conducted a survey of 435 2-3 year medical students of the North Ossetian State Medical Academy (age 20.1±0.08) in seasons with a multidirectional photoperiod trend. In the spring period, 270 students were surveyed, in the autumn – 165. C17 components were assessed from 0 to 3 points, in total they determined the overall sleep quality index (Global Score PSQI, (GS)). We analyzed the sleep time of students, the relationship with latency and sleep duration. Results: The total score (GS) in the spring season was 7.19 (boys – 6.07; girls – 7.51), in autumn – 5.69 (boys – 5.59; girls – 5.75). “Bad sleep” is noted by 66.7% of respondents in spring, and 46.4% in autumn. The main contribution to the proportion of students with poor sleep quality in the spring is made by girls – 71.4%, in autumn, the proportion of students with a good quality of sleep increases, both among girls and boys. In the overall negative assessment of the quality of sleep in the spring, the leading role is played by sleep latency (contribution of 21.5%), in addition, the time of going to bed in 69.7% of medical students shifts to a period after 24:00, provoking a violation of circadian rhythms organism. Conclusion: The overall sleep quality index and the components of the PSQI questionnaire during the survey of medical students have a seasonal dependence. In all the studied seasons, students had a “poor” quality of sleep (more than 5 points), but in autumn, sleep characteristics improved by 21% according to Global Score points. In both seasons, students have 3 groups of symptoms out of 5 main criteria for the diagnosis of insomnia syndrome, which allows us to regard violations of the main components of the sleep index as predictors of the development of adaptive (acute) insomnia.

Tactical Medicine – a Challenge of the Times! Medical University – the Main Provider of First Aid in the Region or a Free Listener?

The article presents the results of the activities of the consortium "First Aid and Digital Health of the Population" and Amur State Medical Academy, as a higher educational institution — a leader and provider of effective education in first aid programs.

Exploring Perceptions of Students and Faculty on the Integration of Research in the Outcome-based Integrated Curriculum: A Qualitative Focus Group Study at Defence Services Medical Academy Myanmar

This study explores the perceptions of students and faculty members regarding the integration of a research component in the Outcome-Based Integrated Curriculum at the Defence Services Medical Academy (DSMA) in Myanmar. Using qualitative focus group discussions, this research investigates the benefits, challenges, and overall impact of this educational initiative. The findings reveal that both students and faculty perceive the research component as beneficial, enhancing knowledge, critical thinking, and presentation skills. However, challenges related to resources, support, and early engagement need to be addressed. Recommendations for improving the research component are provided to strengthen the curriculum and better prepare graduates.

Симуляционное обучение: ключевой элемент профессиональной подготовки медицинских работников в контексте аккредитации.

The article shows the importance of simulation training in preparation for the procedure of primary specialized accreditation of medical specialists. Introduction. Simulation training is gaining popularity, and is gradually becoming one of the most important tools in medical education. It not only improves the quality of education, but also makes it more competitive. Due to the development of professional skills, including decision-making, according to pre-simulated scenarios, students and practicing medical professionals (doctors, paramedics, nurses) receive not only motivation, but also interest in mastering practical skills. In the future, they will be able to apply these skills in their professional activities. Training in simulated conditions also allows medical professionals to prepare for the accreditation procedure (primary, primary specialized). The purpose of this article is to describe the experience of using simulation training in the preparation of students of additional professional education (DPO) at the Department of Nursing Management of the branch of the Military Medical Academy in Moscow for the procedure of primary specialized accreditation (PSA). Materials and methods. We analyzed the results of the procedure of primary specialized accreditation in the specialty «medical care» and «nursing» of students who were trained at the department (nursing management) at the branch of the Military Medical Academy in Moscow in the period from September 2021 to December 2023 and practiced all practical skills in simulated conditions. Results. The analysis of the final tables with the results of the accreditation procedure for nurses and paramedics allows us to conclude that all students in the simulation center have successfully passed the accreditation procedure, training sessions provide students with a high level of training necessary for successful accreditation. Conclusions. Simulation training is an integral part of modern professional retraining and advanced training programs for medical professionals. It is a powerful tool that helps to prepare professional medical professionals for the realities of modern practice. Students and trainees who have completed such training demonstrate a higher level of knowledge, skills and abilities than those who receive traditional education.

Formation of communicative competence of massage therapists with visual impairments: A research study

BackgroundCommunicative competence for massage therapists with visual impairments is an important aspect in ensuring their successful integration into the profession and society. However, visually impaired massage therapists face numerous barriers to effective communication during their education, hiring process, and professional employment. AimTo study why communicative competence is important for students with visual impairments; to research features of communication of persons with visual impairments; to identify barriers and effective strategies for formation of communicative competence in the educational process. DesignA qualitative descriptive study with focus groups and semi-structured interviews. SettingsHigher education institution in Lviv (Ukraine) offering a nursing programme for students with visual impairments. ParticipantsThree groups of respondents, namely visually impaired alumni of Lviv Medical Academy, Ukraine (n = 6), alumni's employers and co-workers (n = 4), and experts in the education of visually impaired persons (n = 11), participated in the research. MethodsTwo focus groups and in-depth semi-structured interviews were used to collect data. Interviews were transcribed verbatim and thematic coding was used to analyze transcripts. ResultsFive themes arose: significance of communication for nurse massage therapists with visual impairments; features of communication of persons with visual impairments; barriers to communication of persons with visual impairments; tools and approaches to improve communicative competence of massage therapists with visual impairments; ineffective methods in teaching communication to visually impaired students. ConclusionsCommunication barriers faced by visually impaired nursing students include isolation in specialized institutions, parental hypervigilance, and the challenge of establishing eye contact, which impedes reading nonverbal cues. To enhance communicative competence, it is essential to implement interactive teaching methods, involve students in various activities, ensure educational accessibility, and adopt an individualized and empathetic approach. Both inclusive and special education have advantages and disadvantages. It is recommended to advocate for a “reasonable accommodation” model to ensure high-quality education for visually impaired massage therapists.

Two-dimensional speckle tracking echocardiography and stress computed tomography myocardial perfusion: potential for early imaging of asymptomatic patients with myocardial bridges

Aim. To evaluate the effectiveness of left ventricular (LV) peak global longitudinal strain and potential of computed tomography myocardial perfusion (CT perfusion) for the early diagnosis of asymptomatic patients with myocardial bridges (MBs).Material and methods. Forty patients were examined (20 with asymptomatic MBs in the area of the left anterior descending (LAD) artery and 20 without MBs) at the S. M. Kirov Military Medical Academy in the period from 2021 to 2023. The patients were divided into 2 equal groups consisting of 20 people (10 with MBs — the main group; 10 without MBs — the comparison group), one of which underwent speckle tracking echocardiography (STE), and the other — stress CT perfusion performed (adenosine triphosphate 160 mg/kg). The results were assessed in accordance with the 17-segment classification of LV proposed by the American Heart Association (2002).Results. When performing STE, 5 (50%) patients with MBs showed a decrease in LV local strain in the segments, the blood supply of which comes from the LAD artery and its branches, while in the comparison group — 1 (10%) (x2=5; p=0,025). When assessing the global longitudinal peak strain (GLPS), a significant difference was revealed among the study groups, amounting to -20,9±1,5% in patients with MBs and -22,1±0,9% in those without MBs (p=0,04). Using ROC analysis, the effectiveness of GLPS in prediction of asymptomatic MBs was calculated as follows: AUC=0,93 (95% confidence interval: 0,819-1,0; p=0,001), the cut-off point — -20,55% (sensitivity 80%, specificity 100%). According to CT perfusion data, impaired myocardial blood supply in the group of asymptomatic patients with MBs was noted in 6 (60%) cases, and in the comparison group — 2 (20%) (x2=9,8; p=0,002).Conclusion. Imaging of initial LV changes according to two-dimensional STE and detection of coronary circulatory disorders according to CT myocardial perfusion in asymptomatic patients with MBs makes it possible to timely suspect intramyocardial course of the coronary artery, as well as to consider further management tactics and carry out early prevention of possible cardiovascular events.

The development of maxillofacial surgery in East Germany: From a municipal hospital to specialised department at the medical academy Dresden.

The transition of the Stomatology Clinic into the Department of Maxillofacial Surgery at the Medical Academy Carl Gustav Carus in Dresden shows how healthcare evolved in East Germany after the Second World War. Founded in 1954 to tackle medical staff shortages, the department grew and specialised over time, becoming a key hub for surgical dentistry in Saxony. Through structural changes, it became a semi-autonomous unit, emphasising patient care and research. By 1983, it evolved into a full Section of Stomatology, streamlining care and training, enhancing expertise and promoting collaboration. Overall, this transformation reflects a significant shift in dental healthcare and academic leadership, shaping surgical dentistry in the region.

Long-term results of treatment of Gustilo-Anderson type 3A-B tibia fractures due to combat-related high-energy ballistic injuries treated with external circular fixator: Experience of the Military Medical Academy.

The aim of this study was to evaluate the longterm outcomes of open tibia fractures treated using the Ilizarov external circular fixation (ECF) technique in the Military Medical Academy. Between January 1992 and December 2011, a total of 134 male military personnel (median age: 22.5 years; range, 18 to 36 years) with Gustilo-Anderson type 3 open tibia fractures treated with ECF were retrospectively analyzed. All patients underwent multiple surgeries and eventually Ilizarov fixation surgery. The radiological and functional outcomes were evaluated using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria, and complications were noted. The median follow-up was 17.7 (range, 10 to 29) years. The median time to union was 4.7 (range, 3 to 8) months. All frames were removed from the limb, when union was observed. No re-fracture, limb length discrepancy more than 2.5 cm, or below-knee amputation after Ilizarov treatment was seen in any patient. Chronic osteomyelitis was observed at in 40% (n=54) of the patients at a median time ranging from 17 to 148 months. The overall ASAMI bone scores were excellent in 40 (30%), good in 20 (15%), fair in 20 (15%), and poor in 54 (40%) patients with osteomyelitis. The ASAMI functional scores were excellent in 40 (30%), good in 40 (30%), and fair in 54 patients (40%). No poor score was observed. Minor pin site infections were observed in 63 patients (47%). Our long-term study results showed that all patients returned to their social life and were mobilized without support after treatment with the use of Ilizarov ECF method of open tibia fractures caused by high-energy ballistic injuries. However, complications such as pin tract infections and osteomyelitis after several years must be kept in mind in the treatment of comminuted bone fractures caused by firearms and ballistic missiles injuries.

Chronicles of A.I. Pospelov Moscow Society of Dermatovenerologists and Cosmetologists (MSDС was founded on October 4, 1891) Bulletin of the MSDС № 1156

On February 20th we held our last meeting of A.I. Pospelov Moscow Society of Dermatologists and Cosmetologists in person. There were 115 participants and 3 applicants. Our agenda included four reports. The first speaker reported a clinical case of cytostatic therapy ineffectiveness in a patient with pustular psoriasis (State Scientific Center of Dermatovenereology and Cosmetology); the second case was about the adverse dermatological reactions in patients receiving pembrolizumab and nivolumab for hepatocellular cancer (Sechenov University). Two reports were presented in the scientific part of the meeting: the first report was about the clinical features of perianal dermatoses (Russian Medical Academy of Continuous Professional Education), the second one was based on the diagnosis of erythroderma (Sechenov University).