Bulletin of the Russian Military Medical Academy
type: channel
description: ISSN (print): 1682-7392, ISSN (online): 2687-1424 Founders: Kirov Military medical academy, Eco-Vector Editor-in-Chief: Evgeniy V. Kryukov, academician RAS, Doctor of Sc., Full Professor Frequency / Access: 4 issues per year / Open Included in: White list (4th level), Higher Attestation Commission List, RISC
publisher: Eco-Vector
language: ru-RU
publication name: Bulletin of the Russian Military Medical Academy
issn: 1682-7392
copyright: Authors who publish with this journal agree to the following terms: Authors retain copyright and grant the journal exclusive license to first publication. Authors are able to distribute the manuscript and/or the article in accordance with Self-Archiving policy of the journal (see details). The manuscript can be accepted for publication only by decision of the Editor-in-Chief and the Editorial board of the journal in accordance with the Manuscript stelection policy of the journal (see details). Published Article will be distributed in print and electronic version an will be available under subscription with Delayed Open Access or in Immediate Open Access under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). The access model depends on the publisher's decision or is determined by a separate Open Access publishing agreement with the authors. An exclusive license for publication granted by authors allows the publisher to use the article in the following ways: Reproduction of the Article or its sections or parts, as well as the metadata of the Article in any languages, in any material form, including on paper and electronic media, as a separate work in the journal and/or databases (local or in the Internet) of the publisher and/or other persons, at the discretion of the publisher; Distribution of the Article or its sections or parts, as well as the metadata of the Article in any languages, on any medium as part of the journal and/or databases of the publisher or other persons, at the discretion of the publisher, or as an independent work around the world whether on Open-Access terms or for a fee without remuneration to the Author; Making the Article or any of its sections or parts, as well as the Article’s metadata in any languages, publicly available in such a way that any person can access the Article from any place, including via the Internet, and at any time of their own choosing; Granting permission/s for the…
items: Cystatin C as a biomarker of acute kidney injury in patients with combat injury
items: Sex- and age-related changes in saliva levels of nitric oxide metabolites in healthy volunteers and patients with cancer
items: Optimization of drug provision for patients with rheumatoid arthritis based on a pharmacoeconomic analysis in the Republic of Kazakhstan
items: Contemporary approaches to early detection of asymptomatic heart disease in patients with hypertension
items: Early diagnosis of upper gastrointestinal disorders in military personnel
items: Multicenter analysis of long-term clinical outcomes of an algorithmic approach to selecting ventral decompressive-stabilizing procedures in two-level degenerative cervical spine disease
items: Impact of combat conditions on casualties and surgical care
items: A risk-based approach to sanitary and hygienic measures for improving compounding performance in pharmacies
items: Potential biomedical use of nanosized cerium phosphate compounds in wound healing
items: Features of collateral portal circulation in the formation of gastric varices in patients with portal hypertension
items: Review of diagnostic approaches for mental and cognitive impairment in post-traumatic stress disorder
items: A personalized approach to current antiplatelet therapy strategies
items: Contemporary diagnosis and surgical treatment of acute traumatic pancreatitis
items: Professor Pavel P. Goncharov, researcher and manager: to his 125th birthday
items: An example of professional and military devotion

Cystatin C as a biomarker of acute kidney injury in patients with combat injury
type: item
description: BACKGROUND: An analysis of the nature of casualties in the context of modern armed conflicts revealed the need to improve the diagnosis of combat injury complications. Acute kidney injury is a multifactorial condition resulting both from injury and systemic dysfunction. Current methods of diagnosing acute kidney injury are inadequate and time-consuming, which results in worse clinical outcomes. Developing innovative systems that can predict acute kidney injury at an early stage will optimize the timing of emergency and intensive care, thereby improving the quality of care provided. AIM: This study aimed to evaluate the diagnostic value of the proposed immunochromatographic test system in semi-quantitative determination of urine cystatin C levels for the prediction of acute kidney injury in patients with combat injuries. METHODS: This was a prospective analysis of the assessment results of 168 patients with combat injury who were admitted to a specialized medical care facility. Urine samples were collected at admission. The obtained material was used determine the threshold urine concentrations of cystatin C with a semi-quantitative method using innovative immunochromatographic test strips. The results were compared to those of the standard diagnosis technique for acute kidney injury, which involved monitoring serum creatinine levels and diuresis rates over time. RESULTS: The innovative test system revealed a high (91.6%) diagnostic value of urine concentrations of cystatin C in predicting acute kidney injury in patients with combat injuries. The sensitivity and specificity of the test was 83.3% and 92.8%, respectively. CONCLUSION: The proposed test for early acute kidney injury prediction should be implemented at the initial stage of medical care to establish evacuation procedures, initiate emergency preventive measures, and select treatment options for acute kidney injury in patients with combat injuries.
creator: Arkadij V. Yazenok
creator: Artem A. Ivanov
creator: Mikhail V. Zakharov
creator: Dmitrii V. Ovchinnikov
creator: Yuri B. Goverdovsky
creator: Pavel V. Agafonov
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 459
ending page: 468
doi: 10.17816/brmma679755

Sex- and age-related changes in saliva levels of nitric oxide metabolites in healthy volunteers and patients with cancer
type: item
description: BACKGROUND: Nitric oxide is a multifunctional signaling molecule that regulates processes such as vasodilation, platelet aggregation, immunotoxicity, and carcinogenesis. Currently, nitric oxide is believed to be involved in the development and progression of tumor lesions. Depending on the concentration, nitric oxide can affect tumor cell apoptosis, metastasis, and angiogenesis intensity. It also demonstrates anti-tumor and cytotoxic properties. Additionally, being the end products of nitric oxide, the total concentration of nitrites and nitrates can be considered diagnostic and prognostic markers for subclinical forms and recurrent cancer. AIM: This study aimed to compare total nitrite and nitrate concentrations in the saliva of healthy volunteers and patients with tumors localized at different sites, depending on sex and age. METHODS: The study included 106 patients, with 74 in the comparison group (healthy volunteers) and 32 in the cancer group. The study participants provided fasting saliva samples (5.0 ± 0.5 mL) in the morning. The samples were collected in plastic test tubes. The total concentration of nitrites and nitrates was determined by spectrophotometry using the colorimetric nitrite diazotization reaction with sulfanilamide and 1-naphthylamine. Nitrates were reduced to nitrites using zinc powder in an alkaline medium containing a copper sulfate-ammonia complex. Next, nitrite ions were quantified. RESULTS: The total concentration of nitrites and nitrates in the saliva samples of healthy volunteers was 129 [59; 261] μM, with nitrites at 109 [36.4; 254.0] μM and nitrates at 6.4 [2.1; 20.9] μM. Nitrate and nitrite concentrations in saliva did not differ statistically between men and women. Nitrate and nitrite concentrations also increased with age. The total concentration of nitrites and nitrates in the saliva samples of patients with tumors at different sites was 14.5 [6.5; 80.1] μM, with nitrites at 9.2 [3.0; 79.4] μM and nitrates at 3.9 [1.5; 7.7] μM. Th…
creator: Tatyana M. Ustinova
creator: Nikolay G. Vengerovich
creator: Anna O. Ivanova
creator: Grigory A. Alper
creator: Mikhail A. Yudin
creator: Alexander S. Partsernyak
creator: Alexey V. Yusupov
creator: Boris S. Kasparov
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 469
ending page: 476
doi: 10.17816/brmma646606

Optimization of drug provision for patients with rheumatoid arthritis based on a pharmacoeconomic analysis in the Republic of Kazakhstan
type: item
description: BACKGROUND: Providing the least costly, safe, and highly effective pharmacotherapy to patients with rheumatoid arthritis remains an urgent issue. AIM: This work aimed to develop approaches for optimizing drug provision for patients with rheumatoid arthritis (using the city of Almaty as an example). METHODS: This work used the information resources of the Ministry of Health of the Republic of Kazakhstan; reports from the Almaty City Rheumatology Center, the State Register of Medicinal Products of the Republic of Kazakhstan, the Clinical Protocol for the Diagnosis and Treatment of Rheumatoid Arthritis No. 12 dated September 29, 2016; wholesale prices for medicinal products, antineoplastic agents, and immunomodulators (anatomical therapeutic chemical groups L01, L04) provided by the City Rheumatology Center; and statistical indicators accumulated based on data from the World Health Organization and the Bureau of National Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan. RESULTS: The highest disease prevalence (60%) was observed among working-age patients aged 35–55 years, whereas only 0.36% of the medicinal products used belonged to biologic agents. The cost ranking (ascending order) of adverse drug reaction therapy was as follows: adalimumab, etanercept, rituximab, tocilizumab, golimumab, and infliximab. With regard to additional cost expenditures, the leading agents (based on the lowest cost of the treatment course) were golimumab, rituximab, and infliximab. The lowest total treatment cost across all treatment stages (in ascending order) was identified for etanercept, adalimumab, and infliximab. CONCLUSION: Strengthening physician-led patient education regarding treatment strategies is necessary to improve adherence among patients with rheumatoid arthritis. To expand therapy options, the inclusion of etanercept in the guaranteed free medical care list must be considered. To reduce expenditures for medicinal provision, producin…
creator: Kairat S. Zhakipbekov
creator: Elmira A. Serikbayeva
creator: Aknur A. Turgumbayeva
creator: Nurgali A. Rakhymbayev
creator: Murat Z. Ashirov
creator: Zhanna V. Mironenkova
creator: Sergey Z. Umarov
creator: Karlygash M. Akpayeva
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 477
ending page: 484
doi: 10.17816/brmma685876

Contemporary approaches to early detection of asymptomatic heart disease in patients with hypertension
type: item
description: BACKGROUND: The onset and progression of hypertension may damage target organs, particularly the heart. This disease is asymptomatic during its early stages. According to Russian guidelines for the treatment of hypertension, left ventricular myocardial hypertrophy is the primary marker of asymptomatic heart disease. Earlier signs may include functional changes in the left atrium, which is detected by speckle tracking echocardiography with longitudinal strain assessment. AIM: This study aimed to assess the efficacy of speckle tracking echocardiography with longitudinal strain assessment in detecting early signs of left myocardial dysfunction in patients with hypertension. METHODS: Segmental and global left atrial and ventricular longitudinal strain was evaluated in patients with hypertension with or without left ventricular hypertrophy and a control group. The longitudinal strain was assessed by analyzing curves of segmental longitudinal strain peaks and rates. Following echocardiography in three standard apical views, software was used to convert data into bull’s eye diagrams. This enabled a comprehensive assessment of global and regional left ventricular contractility using numeric and color parameters. Segmental left ventricular and left atrial longitudinal strain was evaluated using 17 and 6 segments, respectively. RESULTS: No significant differences were found in global left ventricular longitudinal strain parameters between patients with hypertension without echocardiographic signs of left ventricular hypertrophy and healthy individuals. Patients with hypertension (both with and without left ventricular hypertrophy) showed a significant decrease in left atrial longitudinal strain compared to healthy individuals. CONCLUSION: Decreased left atrial longitudinal strain may be the earliest sign of asymptomatic heart disease in hypertension. Impaired longitudinal strain in the left ventricular basal segments is associated with left ventricular hypertrophy in patients…
creator: Alexey N. Kuchmin
creator: Elena P. Galova
creator: Tatiana S. Sveklina
creator: Mikhail B. Nagorny
creator: Andrey N. Filvarkovyi
creator: Andrey A. Shevelev
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 485
ending page: 492
doi: 10.17816/brmma660883

Early diagnosis of upper gastrointestinal disorders in military personnel
type: item
description: BACKGROUND: Subclinical conditions are a primary focus of military medicine because military personnel are routinely exposed to adverse conditions. AIM: This study aimed to evaluate the actual significance of risk factors for esophageal, gastric, and duodenal disorders in National Guard of Russia personnel in order to develop a screening model for upper gastrointestinal diseases. METHODS: A survey included 504 personnel of National Guard of Russia aged 21 to 65 years, who had participated in combat operations. Of these, 197 were officers and 307 were contract servicemen. Their combat tours ranged from 3 to 6 months. Esophagogastroduodenoscopy was performed in 55 respondents (22 officers and 33 contract servicemen). The rank dependence of the risk factors on endoscopic changes was calculated using paired linear correlations. The data were then extrapolated to the entire population (n = 504). RESULTS: The effects of risk factors on disease onset differed among officers and contract servicemen for seven parameters: combat tour duration (p < 0.0001), history of periodic alcohol consumption (p = 0.0153), rushed food intake (p = 0.0020), smoking (p = 0.0116), physical exertion (p = 0.0011), consumption of chemically contaminated products (p = 0.0098), and asthenic body habitus (p = 0.0031). Using Kendall’s tau rank correlation, the relative risk, and the odds ratio, five key risk factors were identified from seven risk factors involved in the development of upper gastrointestinal disorders in the group of officers. These factors included consumption of chemically contaminated products, periodic alcohol consumption, smoking, physical exertion, and asthenic body habitus. CONCLUSION: The evidence has been collected to support the role of certain risk factors in the early diagnosis of upper gastrointestinal diseases. It may be used to generate a screening model for National Guard of Russia servicemen.
creator: Lyudmila A. Ushaeva
creator: Leonid B. Shubin
creator: Dmitry V. Zavyalov
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 493
ending page: 500
doi: 10.17816/brmma681783

Multicenter analysis of long-term clinical outcomes of an algorithmic approach to selecting ventral decompressive-stabilizing procedures in two-level degenerative cervical spine disease
type: item
description: BACKGROUND: Currently, the scientific data lack well-substantiated clinical and radiologic indications for the differentiated use of anterior cervical discectomy with two-level interbody fusion versus anterior cervical corpectomy with single-level transbody fusion in patients with two-level degenerative cervical spine disease. AIM: This work aimed to prospectively assess the long-term clinical outcomes of an algorithmic approach for the selection of anterior interbody cervical fusion versus anterior transbody cervical fusion in patients with two-level degenerative cervical spine disease. METHODS: The treatment of patients with two-segment degenerative cervical spine disease was compared between a prospective cohort (n = 97), operated according to a preoperative clinico-morphologic algorithm in neurosurgical departments in Irkutsk and Krasnoyarsk during 2021–2023, and a retrospective control group (n = 186), operated at the Irkutsk Neurosurgery Center in 2009–2020 using the same surgical techniques according to surgeon preference. RESULTS: After undergoing anterior interbody cervical fusion, the prospective group demonstrated significantly better trends in improvement as compared with the retrospective group, including neurologic function recovery (p < 0.05), regression of pseudoradicular symptoms (p < 0.05), improvement in cervical disability scale indices (p = 0.03) and modified Japanese Orthopaedic Association scores (p = 0.04), improvement in both physical (p = 0.01) and psychological (p = 0.01) SF-36 health components, and better MacNab scale outcomes (p = 0.006). After anterior transbody cervical fusion, the prospective group demonstrated significantly better trends in improvement than the retrospective group did, including neurologic function recovery (p < 0.05), regression of pseudoradicular symptoms (p < 0.05), improvement in cervical disability scale indices (p = 0.03) and modified Japanese Orthopaedic Association scores (p = 0.01), as well as better physic…
creator: Alexander V. Kukharev
creator: Andrei A. Kalinin
creator: Vadim A. Byvaltsev
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 501
ending page: 515
doi: 10.17816/brmma683460

Impact of combat conditions on casualties and surgical care
type: item
description: BACKGROUND: Modern armed conflicts evolve rapidly, resulting in changes in combat scenarios, tactical settings, and military medicine. This, in turn, influences the prevalence of combat-related surgical injuries, with a significant effect on the scope and type of surgical care provided during the early stages of casualty evacuation. The medical evacuation support system established at the beginning of the military operation is currently facing new challenges. These include providing medical care throughout a lengthy prehospital phase as well as the need for specialty care and military medical examination for the increasing number of light casualties in the active army. AIM: This work aimed to assess the prevalence of combat-related surgical injuries as well as the type and scope of surgical care in various combat scenarios of a modern regional conflict. METHODS: Data on casualties that required surgical treatment were pooled and analyzed for several forward medical facilities of individual medical battalions, including those of reinforced combat teams, during a modern armed conflict. RESULTS: Modern warfare is evolving rapidly, as evidenced by the fact that three-fourths of patients admitted to tertiary care were injured as a result of unmanned aerial vehicle attacks. Changes in combat conditions have significantly altered the prevalence of combat-related surgical injuries and the type of surgical care provided. The longer time to casualty evacuation for specialty surgical care is the most significant change influencing the current medical evacuation support system. Other changes, including the decreased proportion of severe and extremely severe wounds (by 15.4%), the increased proportion of minor wounds (by 49.9%), the decreased incidence of penetrating wounds (by 45.2%), and the increased incidence of isolated wounds (by 53.2%), facilitate secondary and tertiary casualty evacuation. CONCLUSION: The changes discussed above are primarily associated with a longer tim…
creator: Rustam R. Kasimov
creator: Mukhamed A. Hezhev
creator: Igor M. Samokhvalov
creator: Anatoliy A. Zavrazhnov
creator: Sergey A. Kovalenko
creator: Vadim A. Рrosvetov
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 517
ending page: 526
doi: 10.17816/brmma649350

A risk-based approach to sanitary and hygienic measures for improving compounding performance in pharmacies
type: item
description: BAKGRAUND: Risk management and effective sanitary and anti-epidemic measures are crucial for improving the efficiency of pharmaceutical compounding. Most pharmacies lack a comprehensive and well-defined algorithm for developing sanitary and anti-epidemic requirements or sanitary and hygienic measures in their standard operating procedures or other local policies. AIM: This work aimed to provide a risk-based, research- and practice-oriented approach to developing standard operating procedures and local regulations to improve sanitary and hygienic measures in pharmacies, including those with the right to aseptic pharmaceutical compounding. The work also aimed to propose an algorithm for implementing these measures into routine practice. METHODS: The work was based on laws and regulations on drug circulation and pharmaceutical activities, research into drug provision and sanitary and anti-epidemic measures in pharmacies, as well as other scientific publications and reference materials on the subject. Latent semantic, historical, structural logical, and content analyses were used. RESULTS: Due to the lack of clear requirements for the implementation of sanitary and hygienic measures, the following risks have been identified: reduced quality and safety of pharmaceutical products; contamination of pharmacy facilities (e.g., process equipment) with various agents, including microorganisms. The fundamental principles of sanitary, hygienic, and anti-epidemic measures in pharmacies were justified. The key sanitary requirements for pharmacies were specified, including interior finishing, ventilation, and lighting, as well as receipt, storage, and transportation of purified water and water for injection. Specific sanitary and anti-epidemic measures were defined for pharmaceutical compounding, including aseptic compounding. A recommended schedule for junior pharmacy staff during sanitary and hygienic measures was provided. CONCLUSION: Pharmacies should make the development and i…
creator: Yuri V. Miroshnichenko
creator: Ekaterina Yu. Alexeichuk
creator: Rimma A. Enikeeva
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 527
ending page: 534
doi: 10.17816/brmma689883

Potential biomedical use of nanosized cerium phosphate compounds in wound healing
type: item
description: BACKGROUND: Skin wound healing is a global public health concern that has a significant effect on quality of life. Ongoing exploratory studies demonstrate the consistently expanding potential of nanoparticles in wound healing. However, although there has been extensive biomedical research of nanoparticles, nanocerium has yet to find use in real-world practice. AIM: This work aimed to examine the biological properties of nanosized cerium phosphate compounds and assess the effect of various concentrations of colloidal solution on the proliferative activity of cells involved in regeneration and skin wound healing. METHODS: Multivalent cerium compounds were manufactured in the form of nanosized cerium phosphate powder, containing both Се3+ and Се4+, as well as methyl cellulose–based nanocomposites. Human fibroblasts were co-cultured with various colloidal solutions of cerium phosphate nanoparticles. The proliferative activity was evaluated using a thiazolyl blue tetrazolium bromide (MTT) assay and direct cell counting with live/dead quantification 72 hours after co-incubation with samples. RESULTS: Cerium phosphate nanoparticles significantly increase the metabolic activity of cells while having no noticeable effect on cell numbers. The most significant effect was reported for cerium phosphate (Ce3+/4+) + methyl cellulose 0.5 g/L as well as cerium(III) phosphate (CePO4-I, CePO4-II) at a maximum concentration of 10−3 M. No samples showed a cytotoxic effect. CONCLUSION: Nanosized cerium phosphate compounds, including methyl cellulose–based nanocomposites, exhibited a significant stimulating biological effect in cell cultures involved in regeneration. This highlights their potential in the development of effective medical devices that contain cerium phosphate particles for healing wounds of various origins. However, the findings do not explain the mechanisms behind this stimulatory effect.
creator: Svetlana A. Dodonova
creator: Alexey A. Kryukov
creator: Victor A. Stupin
creator: Natalia E. Manturova
creator: Elena L. Chuvilina
creator: Akhmedali A. Gasanov
creator: Olga I. Angreeva
creator: Elena B. Artyushkova
creator: Ekaterina V. Silina
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 535
ending page: 546
doi: 10.17816/brmma689101

Features of collateral portal circulation in the formation of gastric varices in patients with portal hypertension
type: item
description: BACKGROUND: Bleeding from esophageal varices and gastric varices is the most frequent and life-threatening complication of portal hypertension is. In 20% to 30% of cases, gastric varices are the source of hemorrhage. Bleeding from gastric varices is more dangerous than bleeding from esophageal varices, due to its greater bleeding volume and persistence as well as the lower therapeutic effectiveness of conventional hemostatic methods. Preventing the development and progression of gastric varices is therefore a key element in managing and preventing portal hypertensive bleeding. AIM: This study aimed to improve algorithms for preventing and treating portal hypertensive gastric bleeding by characterizing the features of collateral circulation within the gastroesophageal region of the portal system in the context of gastric varix formation. METHODS: A total of 137 patients with portal hypertension were examined. The main group included 67 patients with gastroesophageal varices type 1 or type 2 or isolated fundal varices. The etiologic factor of portal hypertension was liver cirrhosis of various etiologies in 37 cases and extrahepatic portal hypertension in 30 cases. Left-sided portal hypertension resulting from isolated splenic vein thrombosis was established in 13 (43.3%) patients with extrahepatic portal hypertension. Subcompensated liver function was identified in 22 cirrhotic patients and decompensated in 15 according to the C. Child – D. Turcotte – R. Pugh classification. The control group comprised 70 patients with portal hypertension and esophageal varices without extension of varices across the gastroesophageal junction. Cirrhosis was the etiologic factor of portal hypertension in 44 patients, whereas the elevated portal venous pressure in 26 patients was due to extrahepatic portal hypertension resulting from portal vein thrombosis. Based on the C. Child – D. Turcotte – R. Pugh classification, subcompensated liver function was noted in 25 cirrhotic patients and …
creator: Ilyia I. Dzidzava
creator: Arif A. Dzhafarov
creator: Sergei A. Alent’yev
creator: Bogdan N. Kotiv
creator: Sergei A. Bugaev
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 547
ending page: 558
doi: 10.17816/brmma690059

Review of diagnostic approaches for mental and cognitive impairment in post-traumatic stress disorder
type: item
description: Post-traumatic stress disorder (PTSD) is becoming increasingly common among military personnel who have participated in combat operations, posing a significant challenge to their normal social functioning. Without effective rehabilitation programs, maladaptive behaviors can become habitual, hindering social integration. Therefore, it is crucial to start the mental recovery process as early as possible. This work evaluated the validity of the diagnostic approaches recommended by the Research Domain Criteria (RDoC) project in evaluating the PTSD severity. We used the RDoC and International Classification of Functioning, Disability, and Health (ICF) domains to evaluate PTSD-associated functional impairment. The work reviewed the syndromic heterogeneity of PTSD, the challenges of differential diagnosis, and the impact of etiological factors on the clinical presentation. We identified three main categories of functional impairment: stress-related behaviors, interpersonal interactions, and cognitive abilities. Diagnostic approaches and research paradigms were proposed to assess and standardize these categories. The RDoC and ICF concepts provide a new perspective on the pathogenesis of PTSD and development of personalized management strategies. It appears promising to enhance specialized diagnostic approaches for this patient population, considering their cultural and mental background.
creator: Dmitrii V. Ovchinnikov
creator: Andrey A. Marchenko
creator: Mikhail D. Gorbachev
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 559
ending page: 568
doi: 10.17816/brmma683256

A personalized approach to current antiplatelet therapy strategies
type: item
description: Antiplatelet therapy, which consists primarily of aspirin (acetylsalicylic acid) and P2Y12 receptor antagonists, is one of the most commonly prescribed treatments in current clinical practice, because of the steadily increasing incidence of cardiovascular disease and the related high mortality rates. Antiplatelet agents are valuable tools for physicians because they can prevent atherothrombotic events, improve clinical outcomes, and reduce cardiovascular mortality rates in primary and secondary prevention. However, secondary bleeding remains a concern with antiplatelet therapy. The current goal of medical science is to minimize bleeding risk in patients at high risk for hemorrhagic events. This review presents data on antiplatelet drugs used in real-world clinical practice. It provides detailed, comprehensive descriptions of their use in various situations and highlights strategies for switching between them. The review also discusses the consequences of high residual platelet reactivity after treatment and summarizes current trends in patient-centered medicine. Additionally, the work revealed the high potential for developing effective and safe agents to counteract the effects of antiplatelet agents. New antiplatelet agents are being developed, such as selatogrel, revacept, and glenzocimab. Further research is required to understand how these potential new agents will integrate into the current antiplatelet therapy paradigm and whether they will promote safer clinical practices. Although significant advances in optimizing antiplatelet therapy have been made through clinical studies, more work is yet to be done. Most genetic intervention studies focus on CYP2C19 polymorphisms in order to personalize antiplatelet treatment strategies.
creator: Dmitriy V. Cherkashin
creator: Sergei L. Grishaev
creator: Andrey E. Alanichev
creator: Alexey D. Sobolev
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 569
ending page: 578
doi: 10.17816/brmma657495

Contemporary diagnosis and surgical treatment of acute traumatic pancreatitis
type: item
description: This review examined Russian and international publications on the diagnosis, classification, surgical treatment, and drug therapy of acute traumatic pancreatitis, a condition caused by pancreatic injury. Pancreatic injuries, although uncommon, typically have an unfavorable prognosis. Timely diagnosis and optimal surgical treatment are essential for the prognosis. Diagnosing pancreatic injury is made challenging by the anatomical position of the pancreas, resulting in delayed treatment. Because of its subclinical course, acute traumatic pancreatitis is frequently difficult to diagnose, especially early after injury. The lack of typical clinical signs is the main cause of diagnostic errors in acute traumatic pancreatitis. This review discusses the contemporary diagnostic techniques for pancreatic injury. Furthermore, it addresses the clinical course of acute traumatic pancreatitis and measures to prevent complications. The American Association for the Surgery of Trauma pancreatic organ injury scale is the primary generally accepted classification for traumatic pancreatic injuries. The main aspects of medical care in modern armed conflicts are highlighted in this review. The surgical treatment of acute traumatic pancreatitis combines conservative management, minimally invasive and conventional open surgeries, and the early prevention of complications. Further research is warranted to develop unified diagnosis and surgical treatment protocols and to assess the long-term treatment outcomes in acute traumatic pancreatitis. The review of published research suggests that this subject is insufficiently studied, highlighting the relevance of this work.
creator: Sergey Ya. Ivanusa
creator: Maksim V. Lazutkin
creator: Daniil N. Ivanov
creator: Zarina O. Gabanova
creator: Anton V. Chebotar
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 579
ending page: 587
doi: 10.17816/brmma678871

Professor Pavel P. Goncharov, researcher and manager: to his 125th birthday
type: item
description: Examining the lives of prominent military physicians is one way to honor our nation’s heroes. Instilling national spiritual and moral values in future generations is vital. This article honors the life and research of Professor Pavel P. Goncharov, a well-known Soviet pathophysiologist who made significant contributions to military medicine. Throughout his lengthy academic career, Professor Goncharov contributed substantially to the establishment and evolution of interoception, a unique branch of science. He demonstrated the efficacy of sulfonamides in the treatment of combat injuries and promoted significant changes in military medicine research, emphasizing the practical applicability of discoveries. Professor Goncharov’s leadership had a significant impact on the S.M. Kirov Military Medical Academy, one of Russia’s oldest and most unique educational institutions. He made an invaluable contribution to the Academy’s history as a researcher, educator, and manager, helping to reform its academic programs and elevate the status of military medical education. Professor Goncharov published more than 80 research works, with the most notable being the monographs “On Cardiac Tamponade” and “On Intestinal Visceral Reflexes.” His work and research are inseparable from the traditions of the Military Medical Academy and its renowned scientific schools. Professor Goncharov is a true example of a military physician who valued service to his country and its people the most. Learning about the lives and work of outstanding scientists shapes the attitudes and motivations of young people who choose to pursue a career in military medicine.
creator: Nikita V. Makeev
creator: Vasily N. Tsygan
creator: Antoniy V. Dukul
creator: Konstantin A. Paliy
creator: Vladislav V. Khusainov
creator: Danil K. Lalaev
creator: Svetlana A. Mamayeva
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 589
ending page: 596
doi: 10.17816/brmma680495

An example of professional and military devotion
type: item
description: This article highlights the life, teaching activities, and research work of Professor Anatoly M. Shelepov, Doctor of Sciences in Medicine, retired Major General of Medical Service. It examines the milestones in his career as a researcher and the head of one of the leading theoretical departments of the S.M. Kirov Military Medical Academy. Anatoly M. Shelepov, a Suvorov Military School alumnus, has always followed Suvorov’s credo, “Never give up!” In his 18 years as department head, he has reached his full potential as a researcher, educator, and academic team leader. Professor Shelepov has consistently expanded the department’s scientific capacity. Approximately 80 doctoral and candidate theses were defended under his supervision. Many of Shelepov’s former students now hold managerial positions in various military and civilian organizations, lead medical services of military districts and branches of the Russian Armed Forces, or work at the Military Medical Academy. In 1998, Professor Shelepov founded the scientific school for military medicine management. In 2003, the federal government recognized the school’s leading scientific status. Shelepov’s fellow researchers proposed theories and concepts for the development of the Russian Armed Forces Medical Service, addressed practical issues of military medicine during armed conflicts and peacetime emergencies, worked on standardization in medical care, and explored the history of military medicine. Since 1993, Professor Shelepov has been a member of the medical geography department of the Russian Geographical Society. Under his supervision, a territorial medical support system was developed; the scope of military medical care during local wars, armed conflicts, and peacekeeping efforts was proposed; and a plan for the Russian Armed Forces Medical Service development until 2030 was established.
creator: Evgeniy V. Kryukov
creator: Evgeniy V. Ivchenko
creator: Andrey A. Zhukov
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2025-12-15
publication date: 2025-12-15
volume: 27
number: 4
starting page: 597
ending page: 604
doi: 10.17816/brmma689202