Russian Military Medical Academy Reports

BACKGROUND: In many works, to study intra- and inter-network connections, a method for constructing networks is used — ROI-analysis (region of interest analysis). The conflicting results obtained when assessing brain connectivity using ROI-analysis can be explained by methodological differences associated with the statistical processing of fMRI data. In this regard, it is relevant to conduct a study with a comparative assessment of various statistical methods of ROI-analysis in processing resting state fMRI data.

AIM: to assess the functional connectivity of the main resting state networks of the brain using ROI-analysis using various statistical approaches.

MATERIALS AND METHODS: We analyzed data from 15 resting-state fMRI studies of the brain of patients without neurological and mental pathology. fMRI scanning was performed on a Phillips Ingenia 1.5 T scanner using a gradient echo-planar imaging (EPI-BOLD) sequence. ROI-analysis was used to build networks. Statistical data processing was performed using methods: functional network connectivity, randomization/permutation spatial pairwise clustering statistics, and threshold-free cluster enhancement.

RESULTS: The number of connections between the structures of brain networks recorded using the method of functional network connectivity is 280, spatial pairwise clustering — 186, threshold-free cluster enhancement — 182. An interesting fact is that negative connections were identified only when using parametric statistics.

CONCLUSION: A comparative assessment of methods for statistical processing of fMRI data during ROI-analysis was carried out. The functional network connectivity method based on multivariate parametric statistics turned out to be more informative than randomization/permutation spatial pairwise clustering statistics and the method based on threshold-free cluster enhancement. Despite the growing popularity in recent years of resting-state fMRI in the study of functional activity and connectivity of the brain, there are no standardized algorithms for constructing networks of the brain.

The objective of this study was to develop a method for forming an antimicrobial wound coating based on chitosan and polyvinylpyrrolidone using 3D printing technology.

The properties of the coating were then studied in vitro and in vivo to improve the treatment outcomes of deep burns. The resulting coating was a 4% hydrogel of medium molecular weight chitosan with the addition of 1% povidone iodine and dermal fibroblasts. After transplantation, the coating was covered with “Foliderm” film. The coating was formed using an extrusion 3D bioprinter, with printing parameters determined experimentally. The samples were first studied in vitro. Scanning electron microscopy was used to evaluate the coating’s microarchitecture and its interaction with dermal fibroblasts. A colorimetric test was conducted to assess cell metabolic activity and cytotoxicity, and antimicrobial activity against reference strains of Staphylococcus aureus was analyzed. An experiment was conducted to evaluate the in vivo properties of the coating. Nineteen male Wistar rats were used in the study. An injury was inflicted that resulted in a deep thermal contact burn, affecting all layers of skin and subcutaneous fatty tissue, with an area of approximately 20 cm². The animals were divided into three groups: experimental (with the application of the developed coating), comparative (using the traditional and widespread method of treatment with Levomekol ointment) and control (without treatment).

The study lasted for 38 days and found that the developed coating is highly biocompatible, atraumatic, elastic, and adheres well to wounds. Chitosan was used to create a porous structure with channels running parallel to each other. The coating cells are evenly distributed on the surface of the matrix, specifically on the walls of the pores. The inclusion of 1% povidone iodine in the polymer resulted in high antimicrobial activity without significantly affecting the activity of the cells in the composition. The experiment on applying a coating for treating deep thermal burns demonstrated that the developed coating had a positive effect on the wound healing process. This effect was characterized by a higher rate of epithelization and a significantly lower incidence of infectious complications compared to other experimental groups. In the histological study, the experimental group outperformed the control and comparison groups in the quality of the formed granulation tissue, the number of newly formed capillaries, and the severity of the local inflammatory process.

BACKGROUND: Currently, there are 33 educational organizations of the Russian Ministry of Defense in Russia with a total staff of about 18 thousand students studying around the clock

AIM: to assess the dynamics of the health status of students in educational institutions of the Russian Ministry of Defense for 12 years from 2010/2011 to 2021/2022 academic year.

MATERIALS AND METHODS: We studied reports on Form 13К/МЕД, prepared by employees of educational organizations of the Russian Ministry of Defense, and calculated the dynamics of the level of assessments of the health status of students. The article presents arithmetic averages and their errors; the development of health groups was assessed using time series analysis, for which a second-order polynomial series was used.

RESULTS: In general educational institutions, there were 25.3 ± 0.9% of pupils with health group I, 60.7 ± 0.6% with group II, and 14.0 ± 1.2% with group III. In recent years, there has been a tendency to increase the number of pupils with health groups I and II and decrease with group III. These results indicated a properly organized educational process and optimization of medical support for students. The most positive dynamics of health status were observed in pupils aged 10–12 years, less pronounced — in pupils aged 16–18 years.

CONCLUSIONS: In some educational organizations of the Russian Ministry of Defense during the period studied, there were not entirely favorable trends in the organization of medical support for students, which aims at more personalized work with students.

The article presents an analysis of the data of modern literature devoted to the study of early diagnosis of wound infection. It is well known that wound healing is a very complex and dynamic mechanism of wound re-epithelialization. At the same time, the normal microflora of the skin plays an important function for maintaining homeostasis and the formation of the skin. There are about 1000 species of microorganisms belonging to the normal flora of human skin and do not cause any harm to healthy people. At the same time, there are microorganisms that, when they enter the wound, lead to the development of infectious complications of wounds as a result of a violation of the integrity of the skin. They include both gram-positive (Staphylococcus aureus, Staphylococcus epidermidis) and gram-negative bacteria (Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, Enterobacter spp., Morganella spp., etc.). Early detection of these microorganisms will contribute to timely and high-quality treatment of wound infection. Currently, there are certain conditions that limit the use of microbiological research methods used to establish a clinical diagnosis of wound infection (long duration, labor intensity, required level of qualification of specialists, etc.). This dictates the need to develop new, fast and easy-to-use methods for diagnosing wound infection. To this end, a group of researchers from Russia (Skolkovo Institute of Science and Technology) and the USA (University of Texas at Austin) have recently developed wearable sensors for the diagnosis of wound infection. These sensors can be embedded in wound dressings and are able to detect certain biomarkers indicating the presence of wound infection. Among these biomarkers, pH and uric acid are the most commonly used, but there are many others (lactic acid, oxygenation, inflammatory mediators, bacterial metabolites or the bacteria themselves). Currently, the development of microelectronics, the emergence of biochemical sensors, active microfluidics and painless microneedles have led to the creation of new generations of wearable biosensors that provide completely new opportunities in the fight against wound infection.

The epidemiological situation of cervical cancer is assessed as unsatisfactory in Russia. The morbidity rate is one of the highest in Europe, and morbidity and mortality rates continue to increase. There were 12,201 new cases of cervical malignant lesions, 6,322 women in our country died from this disease, and the mortality rate was 9.6 per 100,000 women in 2021. At the same time, cervical cancer is one of the few nosological forms of malignant neoplasms that can currently be prevented through vaccination. The disease is suitable for population screening for secondary prevention. Large-scale vaccination against human papillomavirus and properly organized population screening have reduced the mortality rate from cervical cancer to 2 cases per 100 thousand women in 2020 in Australia. If the country continues to stay the course, by 2034 the number of fatalities will be less than 1 in 100,000 per year. The article provides an analysis of current approaches to screening and prevention of cervical cancer worldwide to determine a more effective strategy. We anticipate that the collaborative actions of a health care organization, motivated health care providers, and women interested in their health will lead to a positive trend in cervical cancer prevention in our state.

Uterine leiomyomas are the most common type of benign tumor that occurs in the female pelvis. Uterine leiomyoma is a tumor of smooth muscles. Its prevalence is higher in the reproductive age group and decreases after menopause. Giant uterine fibroids are a rare tumor of the uterus. Giant uterine fibroids, especially subcutaneous types, are complicated by malnutrition due to deterioration of their blood supply. The complaints of the patients are non-specific: an increase in the size of the abdomen, aching pains, sometimes difficulty urinating and defecating. A physical examination reveals a giant abdominal and pelvic formation. Ultrasound with Dopplerometry and contrast-enhanced MRI diagnoses a giant tumor next to the uterus with a heterogeneous structure and the presence of cystic cavities, which is difficult to distinguish from a true large ovarian tumor. The article illustrates the complexity of differential diagnosis of giant tumor of the uterus and ovaries. There are no significant differences between these tumors during ultrasound and MRI examinations. The final diagnosis can be made intraoperativery. The article presents a clinical observation of the giant uterine fibroids of a 48-year-old female patient. Ultrasound and contrast-enhanced MRI revealed a giant tumor of the right ovary, which occupied the entire abdominal cavity, of a heterogeneous structure. Intraoperatively, two tumors, intimately adjacent to each other, 31 cm and 28 cm in diameter, emanating from the isthmus of the uterus, were found. The final diagnosis of uterine fibroids was established histologically. Difficulties in differential diagnosis between uterine fibroids and ovarian tumors before surgery are associated with the large size of the tumor and the heterogeneity of the structure due to its malnutrition.

The article describes the main milestones in the labor, scientific and pedagogical activities of Professor Viktor Pavlovich Baskakov, born on November 28, 1923. After graduating from the Military Medical Academy and defending his dissertation for the degree of Candidate of Medical Sciences in 1950, he was hired as a teacher in the Department of Obstetrics and Gynecology, in 1958 he was appointed to the position of associate professor, in 1970 he received the title of professor, after which in 1974 he became head of department, where he worked until 1984. Viktor P. Baskakov was the first in the country to begin studying endometrioid disease. Three of his monographs are devoted to this complex pathology: “Endometriosis” (1966), “Clinic and treatment of endometriosis” (1979, 1990) and “Endometrioid disease” (2002). In 1968, based on the published monograph “Endometriosis” by V.P. Baskakov was awarded the academic degree of Doctor of Medical Sciences without defending a dissertation. For many years, Viktor Pavlovich was a member of the presidium of the Leningrad Obstetrics and Gynecology Society, a member of dissertation councils, and the editorial board of the Journal of Obstetrics and Women’s Diseases. He was awarded the Order of the Red Star and medals, including the medal “For Military Merit” and the medal “For Victory over Germany in the Great Patriotic War of 1941–1945.” Professor Viktor Pavlovich Baskakov remained in the memory of his contemporaries as a talented scientist, teacher, and surgeon. It was difficult to find a person more concerned about the problems of others. Students remember him with a smile and great warmth.