Methodological approaches to morbidity forecasting in military educational organizations

The article discusses aspects of the application of extrapolation and factor approaches to epidemiological forecasting, outlines the limitations and features of their application in relation to the prediction of morbidity.It is shown that when using an extrapolation approach, it becomes possible to predict the most likely numerical characteristics of morbidity in a certain time perspective. At the same time, the accuracy of the obtained forecast depends on the length of the time series and the type of long-term dynamics of morbidity. In turn, the trends formed by the results of forecasting artificially level the critical levels of morbidity that characterize individual periods of time and are fundamentally important for understanding the real picture.The factor approach is based on the prediction of morbidity levels using a certain set of factors. The difficulty of using the factor approach is noted due to the stochasticity of the epidemic process.Based on the results of a retrospective epidemiological analysis of the personalized morbidity of cadets of the Military Medical Academy, the heterogeneity of military contingents in susceptibility to acute respiratory infections of the upper respiratory tract is shown.From the standpoint of the academician V.D .Belyakov’s et al. theory of the parasitic systems self-regulation, the conclusion is made about the expediency of using a factor approach for epidemiological forecasting of morbidity in organized collectives. It is proposed to use the state of individual resistance as one of the main factors determining the epidemic well-being of organized collectives.The results of the development and testing of an electronic database that allows epidemiological surveillance of the morbidity of trainees and its linear prediction are presented.

Laboratory studies of heated Bulk Fill composite in the tooth cavity during filling of teeth with carious defects

Aim. To study with the help of a microscope the marginal fit of Bulk-Fill group composite materials to the hard tissues of the tooth. Optimize the method of heating the composite in the cavity.Materials and methods. The marginal fit of the composite material of the Bulk-Fill group, sealed in 30 teeth of chewing anatomical and functional accessories extracted according to various indications, was studied. Materials used in the laboratory experiment: 3M ESPE Filtek posterior restorative Bulk Fill, SDR (Dentsply Sirona), Sonic Fill (Kerr). According to the manufacturers, the materials are used with the method of single-portion sealing. The research was conducted at the Department of General Dentistry of the S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation.Results. 30 teeth extracted according to various indications of chewing anatomical and functional accessories were indicators were shown by the Sonic Fill (Kerr) system, due to heating and changing the viscosity of the material.Conclusions. It was proved in the laboratory that the heated composites of the Bulk-Fill group had the best edge fit during sealing than composites at normal room temperature. A nozzle was developed for heating the composite in the tooth cavity (priority application No. 2021120658 dated 12.07.2021).

New data on some Russian herpetologists. Communication 3

Unknown biographic data about I. S. Darevsky, D. B. Krasovsky, and S. A. Chernov are presented. This information was obtained during work with the museum collection of the Gorsky State Agrarian University (Vladikavkaz), that of E. N. Pavlovsky’s Chair of Biology at S. M. Kirov Military Medical Academy, and the archive of the Zoological Institute of the Russian Academy of Sciences.

Treatment outcomes of patients with knee hyaline cartilage damages using osteoperforative methods

BACKGROUND: The treatment of traumatic and degenerative cartilage damage is one of the largest areas in orthopedic practice, and the therapy success remains limited. AIM: To analyze the results of surgical treatment of patients with traumatic and degenerative injuries of the knee joint hyaline cartilage using debridement and osteoperforative techniques, taking into account the time from the surgical intervention. MATERIALS AND METHODS: A statistical analysis was conducted on the treatment outcomes of servicemen with traumatic and degenerative damage in the knee joint articular hyaline cartilage. Patients underwent surgical treatment using osteoperforative techniques (abrasive chondroplasty, tunneling, and microfracturing) at the Clinic of Military Traumatology and Orthopedics of the S.M. Kirov Military Medical Academy from 2009 to 2019. The study relied on the data obtained from questioning the patients using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and LKSS questionnaires. RESULTS: The result analyses using the KOOS and LKSS scales revealed significantly higher good results in the observed group in the postoperative period from 1 to 4 years than in the groups from 4 to 8 and more than 8 years (p = 0.004). No significant differences were determined in the treatment outcomes of the groups with resection and different osteoperforative methods. CONCLUSIONS: Treatment methods for hyaline cartilage defects, such as resection and osteoperforative, are technically simple with good treatment outcomes in patients with articular cartilage injuries from 1 to 4 years postoperative. Treatment outcome deterioration was noted in 48 years postoperative, regardless of the treatment method used, which is more significant in patients in 8 years postoperative.

The history of the research of neuroinfections in the Department of Nervous Diseases of the Imperial Medical Surgical (Military Medical) Academy

The article presents the history of the research of neuroinfections at the Nervous Diseases Department of the Imperial Medical Surgical Academy, later the Military Medical Academy, from 1860 until nowadays. One of the outstanding achievements of Russian and world medicine in the twentieth century, constituting an entire era in neurology and virology, was the comprehensive study of tick-borne encephalitis by Aleksandr Gavrilovich Panov. He made a huge contribution to the research of this infection: Clinic of spring-summer encephalitis (1938) the first journal article in the world literature on the clinical aspects of tick-borne encephalitis; the first Ph.D. thesis on the clinical picture of tick-borne encephalitis was successfully defended by A.G. Panov on February 20, 1939 under the leadership of A.V. Triumfov; the first monograph on tick-borne encephalitis and other encephalitis Seasonal summer encephalitis (Vladivostok, 1940) also belongs to A.G. Panov. The results of the research of tick-borne encephalitis in 19341949 became the subject of a doctoral dissertation, defended on December 8, 1951. In 1956, the classic monograph by A.G. Panov Tick-borne encephalitis was published. At the end of XX and beginning of XXI centuries research work in the field of neuroinfection expanded, studies were carried out in various directions, including neuropathology of herpesvirus, alteration of the nervous system in botulism, acute demyelinating polyneuropathies, neuropathology of chlamydial infection, neuroborreliosis, neuropathology of infective endocarditis, alteration of the blood-brain barrier in meningitis, treatment of neuroinfectious diseases. For more than a century and a half, the staff of the Department of Nervous Diseases of the Imperial Medical Surgical (Military Medical) Academy have created and laid the foundation for the doctrine of neuroinfections for numerous followers, as well as the modern generation of neurologists and doctors of related specialties (bibliography: 10 refs)

Аcinetobacter baumannii bv Tryptophandestruens bv nov. isolated from clinical samples

The aim of the study was to determine the taxonomic status of a group consisting of atypical strains of Acinetobacter baumannii, outline relevant characteristics and methods necessary for their identification. There were examined 10 strains of A. baumannii (6 of them primary comprised) bearing similar profile of atypical features isolated from clinical samples (urine, sputum) in 2017–2019 at the Military Medical Academy. Сlinical strains of typical A. baumannii (n = 36), Acinetobacter nosocomialis (n = 14), Acinetobacter pittii (n = 9) and 1 strain of Acinetobacter calcoaceticus isolated from the external environment were used in comparative studies. Atypical strains had the characteristics of A. calcoaceticus — A. baumannii (ACB) complex bacteria and were identified as A. baumannii. The utilization of substrates as the only carbon source was studied on a dense synthetic medium added with 0.2 % substrate during incubation for 72 hours at 37°C. Carbohydrate oxidation coupled to acid formation was detected on the Hugh–Leifson medium by using a micromethod. Aromatic amino acid biotransformation was carried out in liquid and dense nutrient media assessed in chromogenic reaction. The rpoB gene was used for strain genetic characterization. Amplification of two 940 and 1210 base pair (bp)-long fragments from the rpoB gene was performed by the routine polymerase chain reaction using primers with previously described sequences. Amplification products were sequenced by Sanger using Big Dye Terminator v3.1 (Applied Biosystems, USA) and capillary electrophoresis on an automatic sequencer ABI PRISM 3130 (Applied Biosystems, USA), followed by using methods for determining the similarity levels of sequenced fragments with the rpoB gene sequences of the reference strain A. baumannii ATCC 17978 (GenBank accession no. CP053098.1). It was found that all strains belonging to atypical A. baumannii spp. had a specific set of features that distinguish them from typical strains of A. baumannii as well as other types of the ACB complex: detected biotransformation of L-tryptophan (via anthranilate pathway) and anthranilic acid under unambiguous lack of such signs in other bacteria; lack of utilized sodium hippurate and L-arabinose being unambiguously evident in other bacteria; lack of utilized L-tryptophan, putrescine, L-ornithine being utilized in the majority of strains of belonging to other bacterial species. Genetic analysis showed that the control strains of typical A. baumannii displayed 99.20–99.21% similarity within the sequenced fragments of the rpoB gene with those from the rpoB gene of the reference strain. All 10 strains of atypical A. baumannii had similar features (99.20–99.21%). At the same time, parameters of control strains from other bacterial species significantly differed: A. nosocomialis (95.10–95.97%), A. pittii (94.63–94.92%), A. calcoaceticus (93.00%). Hence, the strains of atypical and typical A. baumannii are genetically homogeneous and belong to the same species. The data presented allow us to consider this group of atypical A. baumannii strains as a new biovar. We propose the name for this new biovar — tryptophandestruens (tryptophan-destroying) stemming from the Latin word destruens — destroying. Identification of A. baumannii bv. tryptophandestruens bacteria can be carried out in laboratory of any level by using tests for L-tryptophan biotransformation as well as sodium hippurate utilization.

The 100th birth anniversary of Ravil Garifovich Imangulov

October 12, 2021, marks the 100th anniversary of the birth of the Head of the Department of Medical Protection, Head of the Department of Armed Defeat and Protection of the Medical Academy, the Great Patriotic War, Doctor of Medical Sciences, Professor, and Colonel of the Medical Service, Ravil Garifovich Imangulov. For many years, R.G. Imangulov fruitfully worked in the field of military medical science and gone through all formational stages of a scientist and a teacher from an adjunct to the head of the department and professor-consultant of the Academic Council of the Military Medical Academy. During his service at the Military Medical Academy, Professor R.G. Imangulov took an active part in testing weapons of mass destruction and special field experimental studies in various regions of the country, aimed at the practical implementation of the latest achievements in the field of medical and technical means of anti-chemical and anti-radiation protection. For a long time, under his leadership and with his direct participation, fundamental research was carried out on the fundamentals of medical protection of troops and population from mass destruction weapons. His achievements in the field of medical protection against mass destruction weapons, both educational and scientific and practical disciplines, are of great importance for Russian military medicine. His fruitful years of activity did not only result in monographs, textbooks, teaching aids, scientific reports, and articles, but also the adaptation of official normative documents for the military personnel protection from mass destruction weapons, technical and medical means of individual, and collective protection.

Outstanding toxicologist: professor Nikolay Vasilyevich Savateev (100th birth anniversary)

The main stages of labor, scientific, pedagogical, and social activities of a participant in the Great Patriotic War, laureate of the State Prize of the Union of Soviet Socialist Republics, honored worker of the higher school of the Russian Federation, doctor of medical sciences, professor, major general of the medical service, Nikolai Vasilyevich Savateeva, are considered. Biographical materials are presented on the formation of N.V. Savateev as an outstanding scientist and teacher, founder of the Department of Toxicology and Medical Protection at the S.M. Kirov Military Medical Academy. Main areas of scientific research personally carried out by Nikolai Vasilyevich, as well as groups that he led for many years, are covered. His interests included fundamental studies of the role of acetylcholine in the higher nervous activity function, mechanisms of toxic action of organophosphorus compounds and other neurotoxicants, and the search for antidote therapy for these compound poisoning. In 1967, he was awarded a State Prize of the Union of Soviet Socialist Republics for developing and creating antidotes for organophosphorus toxic substances. Nikolai Vasilievich made a significant contribution to the military toxicology and medical protection formation as a training discipline and branch of military medical science. He was one of the first scientists worldwide to begin the study of biomedical consequences of chemical accidents and problems of environmental toxicology. In subsequent years, Nikolai Vasilievich was one of the initiators to develop the disaster medicine problem. The most important place in the activities of N.V. Savateev was occupied by training scientific and pedagogical personnel, who continued the work of their teacher; many of them became well-known toxicologists in our country and abroad.

Choledocholithiasis: modern possibilities of diagnosis and surgical treatment

Studies have examined various approaches in the diagnosis and surgical treatment of patients with cholelithiasis complicated by choledocholithiasis, evaluated the possibilities of using modern methods of treating the disease, and proposed a strategy to prevent the abandonment of bile duct concretions. The relevance of this problem is related to the variety of diagnostic and surgical treatment methods of choledocholithiasis, high disease frequency, and nonexistence of a unified approach to the examination and choice of surgical treatment in patients with cholelithiasis complicated by choledocholithiasis. These issues indicate the need to study this problem and identify optimal approaches to examination and treatment, including modern minimally invasive methods of treatment. The analysis of the diagnostic value of various examination methods and surgical outcomes was based on the experience of treating 154 patients with cholelithiasis complicated by choledocholithiasis in the clinic of the S.P. Fedorov Faculty of Surgery of the S.M. Kirov Military Medical Academy. An algorithm for examining patients with cholelithiasis was formed based on the diagnostic value of various research methods, which allows timely detection of choledocholithiasis. The results of various approaches to the surgical treatment of patients with cholelithiasis complicated by choledocholithiasis were analyzed. In the absence of general somatic contraindications and the availability of technical capabilities, a one-stage approach to surgical treatment was suggested. Moreover, an individual approach is necessary for the treatment of patients with cholelithiasis complicated by choledocholithiasis, taking into account the nature of the disease course and its complications, comorbid status of the patient, and technical capabilities of a particular hospital. The sequence and timing of operations with a two-stage approach should be determined, taking into account the acute conditions and comorbidities of the patient. The use of modern minimally invasive technologies, such as transpapillary and trans-bubble choledochoscopy, dosed papillotomy, and rendezvous technique for the cannulation of the large papilla of the duodenum, allows us to improve the results of surgical treatment and reduce the risk of complications. Transpapillary and trans-bubble nanoelectroimpulse lithotripsy are alternative methods of resolving major choledocholithiasis in both one-stage and two-stage treatment.

Professor Alexander Mozzhukhin (by the 100th anniversary of his birth)

Alexander Sergeevich Mozzhukhin was born on August 27, 1921, in Krasnsodar in a family of an employee. After graduating with honors from high school, A.S. Mozzhukhin became a student at the Kuibyshev Military Medical Academy and completed his medical education with honors at the military faculty of the 2nd Moscow Medical Institute. In 1943, A.S. Mozzhukhin came to the Department of Normal Physiology of S.M. Kirov Military Medical Academy, with whom he connected more than 30 years of his life and in which he went from adjunct to head of the department, and scientific secretary of the academic council of the academy. The scientific activity of A.S. Mozzhukhin began in the life-giving atmosphere, which was formed at the department during the leadership of Academician L.A. Orbeli and his closest assistant A.V. Lebedinsky. All scientific activity of A.S. Mozzhukhin is an organic and natural combination of fundamental problems, physiology, psychophysiology, human biology, and practical medicine. The main scientific direction of the Department of Normal Physiology under the leadership of A.S. Mozzhukhin was on the study of the interaction of afferent systems under exposure to extreme stimuli as well as on the study of human functional reserves. In addition, a team examined the physiological cost of pedagogical activity depending on the age, seniority, psychophysical characteristics of teachers, and type of training sessions. A.S. Mozzhukhin investigated the biological effects of ionizing radiation. Together with chemist F.Yu. Rachinsky, he created a radio defense drug RS-1 and became a leading Soviet radiobiologist. A.S. Mozzhukhin created a unique scientific physiological school of the S.M. Kirov Military Medical Academy, which scientifically proved that the adaptation process was accompanied by the formation and improvement of a specific system of functional reserves for body adaptation, and the systemic factor was the result of the activity (adaptation). A.S. Mozzhukhin, while working at P.F. Lesgaft Institute of Physical Culture, proved that functional reserves have potentials in changing the functional activity of structural elements of the body and their interaction among themselves to achieve the target result, adapt to physical and psychoemotional loads, as well as the effect of various factors of the external environment on the body. The bright memory of Alexander Sergeyevich Mozzhukhin will forever remain in the hearts of his students and followers.