Vol 42, No 1 (2023)

Original articles

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

Kukhtalev V.V., Dorofeev I.I., Yusupov V.V., Golovko K.P., Shibaeva A.G.

Abstract

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.

Russian Military Medical Academy Reports. 2023;42(1):5-13
pages 5-13 views

The interrelation of psychological characteristics and success of education of cadets of civil aviation

Sazonov Y.V., Sinel’nikov S.N., Dudina E.A., Sokolov I.R., Shmurak E.S.

Abstract

BACKGROUND: Historically, the development of professional selection, occupational hygiene, and psychology occurs to the greatest extent in aviation, because it has been proven that up to 50–80% of flight accidents are directly related to the human factor. So, S.E. Mints, an aviation military doctor, after analyzing 364 plane crashes, came to the conclusion that in 90% of cases of disasters, the decisive factor is the individual qualities of pilots. Determining the typical personal characteristics of suitable and unsuitable persons for the flying profession is a rather difficult task facing professional selection specialists. Primary professional training of a pilot is carried out in flight schools and is improved during their further work. One of the main goals of flight training is the formation of a trained pilot with strong professional skills in piloting an aircraft, ensuring flight safety. The study examines the psychological characteristics that affect the success of cadets both in theoretical training and when performing exercises on simulators.

AIM: to study the influence of psychological characteristics on the success of training cadets of civil aviation.

MATERIALS AND METHODS: The statistical analysis of significant differences between “successful” and “less successful” students was carried out according to the following methods: R.B. Kettell’s 16-factor personality questionnaire (form C); Lazarus’ questionnaire “Coping behavior methods”; G. Aizenk’s Personal questionnaire (EPI); The method “Motives for choosing a profession” (author R.V. Ovcharova); Questionnaire “Styles of self-regulation of behavior (author V.I. Morosanova).

RESULTS: In theoretical training, those students who are dominated by calmness, self-control, equanimity and emotional stability are more successful. They are characterized by stable interests, developed will and determination, as well as independence, flexibility and non-hostility. The most successful in performing exercises on simulators are students with developed abstract thinking. They are quick-thinking, easy to learn. They are distinguished by determination, enterprise, and activity in achieving goals. These students are ready to act alone, independent and independent. They are characterized by activity, concentration and a high level of motivation. They are characterized by a rational approach to solving problematic situations.

CONCLUSION: The most successful in performing exercises on simulators are students with developed abstract thinking. They are quick-thinking, easy to learn. They are distinguished by determination, enterprise, and activity in achieving goals. These students are ready to act alone, independent and independent. They are characterized by activity, concentration and a high level of motivation. They are characterized by a rational approach to solving problematic situations. It was revealed that those students who have the following psychological characteristics are more successful in the course of theoretical training: high indicators on the scales of emotional stability–instability, relaxation–tension, planning, the general level of self-regulation and low indicators on the scale of confrontation, and when performing exercises on simulators: high scores on the scales of intelligence, timidity–courage, conformity–nonconformity, relaxation–tension discipline, self-control, acceptance of responsibility, flexibility, independence and low indicators of the search for social support factor and, according to the scale, internal individually significant motives for choosing a profession.

Russian Military Medical Academy Reports. 2023;42(1):15-21
pages 15-21 views

Cell-based therapy in thin endometrium syndrome

Tapil’skaya N.I., Ob’edkova K.V., Gzgzyan A.M., Bespalova O.N.

Abstract

Of the known causes of uterine factor infertility, Asherman’s syndrome or the so-called intrauterine synechia, chronic endometritis and endometrial hypoplastic processes are most often distinguished. Thin endometrial syndrome is characterized by a decrease in the thickness of the endometrium to 7 mm or less in the proliferative phase of the menstrual cycle and a multiple decrease in the frequency of embryo implantation.

Numerous treatment strategies have so far been proposed for treating refractory thin endometrium syndrome. Recently, cell therapy has been proposed as an ideal alternative for endometrium regeneration, including the employment of stem cells, platelet-rich plasma, and growth factors as therapeutic agents. Single center, prospective, open-label study of efficacy of cell-based therapy in the complex treatment of thin endometrium syndrome in patients with infertility was conducted. The study involved 36 women aged 28 to 36 years, the middle age was 34.2 ± 1.1 years. All patients included in the study received 3 cycles of intrauterine administration of a suspension of autologous stem cells isolated from bone marrow. Bone marrow was successfully aspirated from the iliac crest in all patients. Mononuclear cells was isolated by density gradient centrifugation according to the standard method. The cell material was cryopreservated and thawed immediately before administration. The procedure for intrauterine transplantation of isolated but not cultured cells was performed on the 5th–7th day of the menstrual cycle. There were no significant adverse events related to harvest or administration. The thickness of the endometrium before and after treatment was 2.39 ± 0.64 and 6.56 ± 0.94 mm (t = –21.94, p = 0.0001), respectively. The rate of patients with an endometrial thickness of more than 7 mm after treatment was 77.8%. The effectiveness of assisted reproductive technology in patients with normal endometrial (n = 28) was 32.1%. Immunohistochemistry confirms the presence of chronic endometritis before and after treatment in 22 (61.1%) and 19 (52.8%) patients, respectively, while after treatment a significant decrease in the levels inflammatory markers was found.

Russian Military Medical Academy Reports. 2023;42(1):23-28
pages 23-28 views

Some features of the immune system response in the new coronavirus infection COVID-19

Protasov O.V., Bolekhan A.V., Arzhavkina L.H., Bogdanova E.G., Chugunov A.A.

Abstract

AIM: to study the cytokine link of immunity in patients with the new coronavirus infection COVID-19 and the possibility of using these data to predict the risk of lung tissue damage.

MATERIALS AND METHODS: Patients with diagnosed new coronavirus infection COVID-19 were divided into 4 groups depending on the severity of the disease: 1 — asymptomatic patients; 2 — patients with lung tissue damage in the amount of 25%; 3 — patients with lung tissue damage 50%; 4 — patients with lung tissue damage 75% (according to the results computed tomography). Immunological studies were performed upon admission to the clinic, then after 7 days and before discharge. The concentration of cytokines in blood serum was studied by the method of solid-phase enzyme immunoassay using kits manufactured by Vector Best.

RESULTS: In all groups, a low content of proinflammatory cytokines was found: tumor necrosis factor and interferon-γ, interleukin-1, interleukin-2. The median level of interleukin-6 in all groups during the entire follow-up period was within the normal range, however, in some patients there was a multiple excess of its concentration. In groups with 50% and 75% lung tissue damage, an increase in the concentration of interleukin-8 was shown. Statistically significant differences were noted only for the level of interleukin-8 between the group with an asymptomatic form of infection and the CT-2 and CT-3 groups. It was found that the concentration of interleukin-1 below 3.58 pg/ml is a significant risk factor for severe disease. In all groups of subjects, low levels of interleukin-4 and interleukin-10 were noted, while there was no significant difference between the groups. Positive correlations were revealed between the degree of lung tissue damage and the level of interleukins 6, 2 and 8. Negative correlations were established between the degree of lung tissue damage and the content of interleukin-1.

CONCLUSION: There was no significant activation of the cytokine link of adaptive antiviral immunity in the examined contingent. Serum cytokine levels were within normal values and had no significant intergroup differences. An increase in IL-8 in groups with clinically pronounced signs of infection indicates the activation of indicators characterizing innate immunity.

Russian Military Medical Academy Reports. 2023;42(1):29-36
pages 29-36 views

Improvement of quality control of water for pharmaceutical purposes obtained in the field

Enikeeva R.A., Miroshnichenko Y.V., Alekseychuk E.Y.

Abstract

The important component of military healthcare activities is development of new models of complete scheduled medical supplies, including those intended for the produce and quality control of medicines in military pharmacies and in military field hospitals. The article presents data of the creation of a self-sufficient set that allows to monitor the quality of purified water and water for injection in the field during a specified period. Now the available complete scheduled medical supplies do not contain materials and items for water quality control.

The goal of the article was to substantiate the approaches to the creation of a set “Complete scheduled medical supplies for monitoring the quality of purified water and water for injection” (CQW), the selection of the nomenclature and the determination of the amount of materials and items necessary for its completion, also the assessment of patentability. The CQW is a set with regulated property in terms of composition and quantity, which are statically fixed in a plastic container and ready for use. There are advantages set indicated (self-sufficiency, portability, protection from the effects of external environmental conditions, etc.).

The authors of the article make a conclusion about the patentability of the product (application for invention N 2023101440). At the end of the article, the conclusion is formulated that the inclusion of the CQW in the composition of the complete scheduled medical supplies will improve the production activities of military pharmacies in the field, which will greatly contribute to improving the efficiency of medical care for the wounded and injured in military conflicts and extreme situations.

Russian Military Medical Academy Reports. 2023;42(1):37-42
pages 37-42 views

Review

Genetic factors of early termination of pregnancy

Tsechoeva L.S., Dementyeva E.I., Leonova M.D., Poloskov A.I., Gavrichkova Y.V., Bardinova M.V., Tapil'skaya N.I., Slizhov P.А., Glushakov R.I.

Abstract

Pregnancy loss and premature delivery are combined by the definition Premature Termination of Pregnancy, while these conditions affect up to 5% of women of reproductive age. In some cases, genetic components are both etiologic and pathogenetic factors of premature birth, however, This challenge is further complicated by the fact that extensive population-based genetic studies and subsequent validation of the data are required, especially in multi-ethnic populations.

Genome-wide studies will demonstrate polymorphic variants of hundreds of genes that are candidates for being associated with termination of pregnancy, including those regulating embryo implantation, pregnancy support, and immune system response. The review provides information about the genes and genetic polymorphisms that are involved in the regulation of the female reproductive system and associated with premature birth. A special role in the genetic mechanisms of miscarriage and/or preterm birth belongs to steroid hormone receptors, enzymes of the arachidonic acid metabolism, pro- and anti-inflammatory cytokines. However, the infectious factor takes the first place as a leading one, forming cause-and-effect relationships in the chain of pathogenetic links or giving modality to other factors. Most often, it is genetic polymorphisms associated with an over-activity of the immune system that underlie premature termination of pregnancy.

Subsequent Investigation of the human genome, epigenome, and transcriptome helps to identify molecular mechanisms linked with preterm delivery and premature newborn clinical appearance in early and late neonatal life and even predict developmental outcomes. These data could be used to develop targeted interventions aimed at selecting the most effective individual treatment and rehabilitation plan. The data obtained in future studies could be used to develop for preconception care, targeted therapy and the most effective individual treatment plan.

Keywords: genetic polymorphism; miscarriage; over-active immune responses; premature birth; premature termination of pregnancy; transcriptome.

Russian Military Medical Academy Reports. 2023;42(1):43-53
pages 43-53 views

Aortic dissection: computed tomography characterization of the true and false lumen in acute and chronic stages

Sadykova G.K., Zheleznyak I.S., Amosov V.I., Ryazanov V.V., Bagnenko S.S., Ipatov V.V., Latysheva A.Y.

Abstract

Aortic dissection is a longitudinal rupture of the aorta associated with the destruction of the middle layer of the aortic wall, the separation of intima and adventitia and the formation of two lumens, which is an urgent condition requiring emergency surgical care. The presented illustrated literature review is devoted to the differentiation of true and false lumens in the acute and chronic stages of aortic dissection during computed tomography.

The article summarizes and systematizes the experience of computed tomography diagnostics in aortic dissection based on data available in domestic and foreign publications, as well as the results of their own clinical observations. We have identified the main and secondary signs detected by computed tomography in cases of aortic dissection.

The most important and unambiguously indicative of false lumen in classical acute and chronic aortic dissection are the larger size of the false lumen, the sign of a “beak” and the sign of a “web”. Other signs, such as calcification of the aorta, changes in the curvature and thickness of the intimal medial flap, the “Mercedes-Benz” symptom, the presence of thrombotic masses, the characteristics of the interposition of the lumens and the “wind indicator” symptom are less constant, however, a careful analysis of the totality of all secondary signs allows you to give important diagnostic information and characterize as fully as possible the manifestations significant for a cardiovascular surgeon dissections of the aorta.

A cumulative analysis of computed tomographic signs in cases of aortic dissection will help a practicing radiologist not only distinguish the true lumen from the false aorta, but also determine the stage of the process based on their characteristics, which affects the tactics of complex treatment, especially with atypical dissection.

Russian Military Medical Academy Reports. 2023;42(1):44-64
pages 44-64 views

By-products of disinfection of potable water at placing of armies in field conditions

Plakhotskaya Z.V., Andreev V.P., Krivtsov A.V.

Abstract

On the basis of studying of the data published in open sources, the problem of the comparative characteristic of potential danger of various methods of disinfection of water about formation in process or as a result of its clearing of the substances possessing toxic and (or) cancerogenic action dared. Application of practically all methods, both traditional, and perspective is established, that is accompanied by formation of by-products of disinfection directly in potable water or as a part of drains in the form garbage removed from the water.

Now the most widespread, effective and economic way of disinfection water is the use of chlorine-containing preparations. Such approach provides destruction of the majority of pathogenic microorganisms that defines the application of chlorine-containing preparations in world practice of clearing and water disinfecting in spite of the fact that at their use there is a formation of the big number of products of collateral disinfection.

As concentration of the last depends on parameters of the process of disinfection, to solve a safety problem it is offered by strict observance of conditions of technological process, instead of prohibition of application of those or other techniques.

The most perspective for water preparation perfection in the field conditions, having the least quantity of by-products of disinfection, is the approach to disinfecting of water which includes two alternative systems: reverse osmosis and an ultrafiltration (and in the long term — nanofiltration) with possibility of a choice of one of these variants of clearing.

As concentration of the last depends on parameters of the process of clearing, to solve a safety problem it is offered by strict observance of conditions of technological process, instead of prohibition of application of those or other techniques.

The basis for refusal of connection of field camp to the centralised networks of water supply and use of the chlorinated potable water is not revealed.

Russian Military Medical Academy Reports. 2023;42(1):65-74
pages 65-74 views

Case report

A rare clinical case of uterine cancer with a congenital malformation of the genital organs

Borshchevskiy V.G., Ul’rikh Е.A., Zakharov I.S., Shmidt A.A., Solomko D.V., Gadzhiev S.Z.

Abstract

Endometrial cancer is one of the most common options malignant neoplasms of the female reproductive system. At the same time, in the general structure of female oncopathology, cases of this disease in patients with developmental anomalies of the genital organs are extremely rare. When studying scientific publications, only 26 described clinical cases of uterine cancer in patients with genital malformations were found. The article presents a clinical case of endometrioid carcinoma in a 75-year-old woman with a duplication of uterus. Based on clinical performance, ultrasound investigation results, magnetic-resonance imaging and histological studies of endometrial scrapings was diagnosed duplication of uterus with endometrial cancer IB (cT1вNхМ0), G2 (morphological type — endometrioid carcinoma). With this pathology, surgical treatment is considered as the most effective way to fight uterine cancer, in some cases combined with other methods. Both laparotomic and laparoscopic interventions are recommended, provided that pelvic and lumbar lymph node dissection can be performed according to indications. The operation was carried out in the amount of laparotomy, B2 — type modified radical hysterectomy, with C3 pelvic lymph node dissection, omentectomy. The result of the postoperative histological examination confirmed the preoperative diagnosis. The postoperative period was without specific findings. The presented rare clinical case demonstrates necessity to give careful attention to patients with a congenital malformation of the genital organs. Timely diagnosis and diagnosis verification will allow for adequate treatment, which will affect the prognosis of survival. At the same time, the prognosis is largely determined by the stage of the process, the depth of the invasive lesion, and the histological type of the tumor.

Russian Military Medical Academy Reports. 2023;42(1):75-82
pages 75-82 views

Discussion

Ultrasound and computed tomography diagnostics of ovarian cyst rupture with hemoperitoneum

Sadykova G.K., Zheleznyak I.S., Ryazanov V.V., Khodkevich I.S., Ipatov V.V., Latysheva A.Y., Oppedisano M.L.

Abstract

The presented article is devoted to the issue of diagnosis of rupture of ovarian cyst complicated by hemoperitoneum. Ovarian apoplexy ranks third in the structure of urgent diseases in gynecology and second among the causes of intra-abdominal bleeding. It is a sudden hemorrhage into the ovarian tissue, accompanied by a violation of the integrity of its tissue and in some cases bleeding into the abdominal cavity, may be asymptomatic or accompanied by the sudden appearance of unilateral pain in the lower abdomen. In the conditions of emergency rest during emergency diagnostics, the main advantage of ultrasound is the ability to perform in any conditions and in any condition of the patient, therefore, this method is considered in the scientific literature as the main one for the initial examination of such patients, nevertheless, in the scientific literature there is information about the differential diagnosis of emergency gynecological conditions accompanied by hemoperitoneum by X-ray computed tomography.

The article presents the signs detected during ultrasound diagnostics and computed tomography in case of rupture of an ovarian cyst, systematized on the basis of literature data and our clinical experience. The main ultrasound and CT symptoms are intraperitoneal effusion with the presence of a “sentinel thrombus” in the injured ovary and cystic formation in the ovary.

The combined analysis of these signs will help the practitioner in an urgent situation not only to determine the blood in the abdominal cavity, but also to determine the source of bleeding, as well as to differentiate the rupture of the ovarian cyst from other conditions accompanied by acute abdominal pain syndrome.

Russian Military Medical Academy Reports. 2023;42(1):83-90
pages 83-90 views

History of medicine

80 years of the Faculty of training doctors for Missile, Land and Airborne Troops of the Military Medical Academy and its first graduation

Bolt A.V., Golubtsov O.Y., Gerfanov R.N.

Abstract

November 25, 2022 marked the 80th anniversary of the establishment of the Faculty of Training Doctors for Missile, Land and Airborne Troops of the Military Medical Academy, and June 22, 2023 will mark the 80th anniversary of its first graduation. A real historical study is devoted to these anniversary events. Based on archival and literary data, the main stages of the development and formation of the faculty are traced, its contribution to the training of military medical personnel is shown. The faculty is essentially the same age as the Academy, for this reason, the analysis of the modern views of the historians of the Academy on the date of its foundation was carried out. Based on previously published data, it is shown that the starting point of the academy’s existence is the decisions of Peter I on the establishment of general hospitals and medical schools in 1715. Brief biographical references of the heads of faculties are given, many details have been clarified in recent years and were absent in earlier editions. The role of Major General of the medical service L.N. is separately indicated. Obraztsova participated in the collection and preservation of historical data about the faculty, the creation of a museum and first editions and articles. The service and scientific achievements of graduates of the faculty, their contribution to science and education are described. Special attention is paid to participation in armed conflicts and Special military operations, as well as the fight against the pandemic of a new coronavirus infection. The actual data on graduates of the faculty, which can be used in military-historical work, are also given. The work complements and expands both the general information about the faculty and supplements the information accumulated over the past 10 years, since the last publication about the faculty.

Russian Military Medical Academy Reports. 2023;42(1):91-99
pages 91-99 views


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