Russian Military Medical Academy Reports
type: channel
description: ISSN (print): 2713-2315, ISSN (online): 2713-2323 Founders: Military Medical Academy; "Eco-Vector" LLC Editor-in-Chief: Kryukov Evgeniy Vladimirovich, Academician of the Russian Academy of Sciences, Doctor of Medicine. sciences Frequency / Access: 4 issues per year / Subscription Included in: RISC
publisher: Eco-Vector
language: ru-RU
publication name: Russian Military Medical Academy Reports
issn: 2713-2315
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: Ischemic stroke in combat conditions. Vasculocerebral injury
items: Post-traumatic epilepsy as a consequence of gunshot penetrating head injury with intracranial metallic foreign body: epidemiology, prevention, and treatment algorithms
items: New approaches to spasticity management after spinal cord injury: application of multilevel magnetic stimulation
items: Comparative effectiveness of medical care for patients with in-hospital ischemic stroke in primary stroke units and regional comprehensive stroke centers
items: Risk factors and differential prevention of in-hospital hemorrhagic stroke
items: Acupuncture therapy in the late recovery phase of facial nerve neuropathy
items: Key risk factors and a prognostic model for vascular myelopathy
items: Comorbidity and differential diagnosis of idiopathic normal pressure hydrocephalus and Alzheimer disease
items: Event III. Eastern medicine in Russia. The 21st century. Contemporary directions of the Leningrad–St. Petersburg school
items: Molecular epidemiology of malaria vector mosquitoes in coastal areas of Southern Vietnam
items: Current concept of gastroesophageal reflux disease: a review
items: On methods of blood pressure measurement: to 120th anniversary of N.S. Korotkoff’s discovery
items: Mirror-image type III complete duplication of inferior vena cava: a distinct classification subtype or a variant of an existing one?

Ischemic stroke in combat conditions. Vasculocerebral injury
type: item
description: During armed conflicts, the incidence of ischemic stroke among military personnel increases substantially compared with peacetime. In addition to the elevated risk of combat-related injuries, military service members are exposed to intense physical and emotional stress and extreme environmental factors, which contribute to the toll of both common (atherosclerotic arterial changes, diabetes mellitus, obesity, cardiovascular diseases) and specific risk factors more typical of young adults (cardiac sources of embolism, non-inflammatory and inflammatory arteriopathies, coagulation disorders), as well as generate additional stroke risk factors unique to combat conditions. Firearm injuries have a special place in the pathogenesis of combat-related ischemic stroke. We have proposed and substantiated the term vasculocerebral injury. It is a distinct type of combat firearm injury, representing a cascade of sequential interrelated pathological changes occurring in the damaged major precerebral arteries (aorta, brachiocephalic trunk, common and internal carotid arteries, vertebral arteries), cerebral arteries, their vascular territories, blood cellular elements, and surrounding tissues as a result of the complex damaging effect of a high-energy projectile (shock wave, lateral impact energy, vortex flow), ultimately leading to pathophysiologically heterogeneous secondary acute cerebrovascular lesions, including ischemic stroke. Clinical cases of vasculocerebral injury are presented. Early identification of cervical and cranial vascular injuries contributes to timely and optimal treatment tactic selection (surgical, conservative, including differentiated antithrombotic therapy) and improves ischemic stroke prevention during combat operations.
creator: Igor V. Litvinenko
creator: Nikolay V. Tsygan
creator: Sergey V. Kolomentsev
creator: Sergey Yu. Golokhvastov
creator: Ruslan V. Andreev
creator: Miroslav M. Odinak
creator: Dmitriy V. Svistov
creator: Aleksandr V. Savello
creator: Kirill V. Kitachev
creator: Vasiliy O. Nikishin
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: 2025-11-05
publication date: 2025-11-05
volume: 44
number: 4
starting page: 367
ending page: 380
doi: 10.17816/rmmar693124

Post-traumatic epilepsy as a consequence of gunshot penetrating head injury with intracranial metallic foreign body: epidemiology, prevention, and treatment algorithms
type: item
description: BACKGROUND: The growing number of armed conflicts worldwide is leading to an increase in patients with combat-related traumatic brain injury, including those with intracranial metallic foreign bodies. Acute symptomatic post-traumatic epileptic seizures constitute a cause of secondary brain injury, whereas post-traumatic epilepsy may become the only disabling and quality-of-life-limiting consequence of head trauma, requiring prolonged antiseizure therapy. AIM: This work aimed to investigate epidemiological features, diagnostic characteristics of epileptic seizures, and post-traumatic epilepsy in military personnel with intracranial metallic foreign bodies, and to evaluate algorithms for preventive antiseizure medication and treatment of post-traumatic epilepsy. METHODS: A prospective study included 93 military personnel who sustained a gunshot penetrating head injury with an intracranial metallic foreign body. Patients were divided into two groups: group 1 (n = 63) with intracranial metallic foreign body retained; group 2 (n = 30) with intracranial metallic foreign body surgically removed within 4 months post-injury. To assess different approaches to preventive antiseizure therapy, both groups were subdivided into two subgroups: patients receiving prophylactic antiseizure medications (1a and 2a); patients without prophylactic antiseizure treatment (1b and 2b). RESULTS: Post-traumatic epilepsy was diagnosed in 18 of 93 patients (19.4%). In group 1, a total of 13 patients (20.6%) developed epilepsy: 8 of 27 (29.6%) in subgroup 1a and 5 of 36 (13.9%) in subgroup 1b. In group 2, epilepsy occurred in 5 patients (16.7%): 4 of 16 (25%) in subgroup 2a and 1 of 14 (7.1%) in subgroup 2b. Among group 1 patients with post-traumatic epilepsy (n = 13), epileptiform activity on electroencephalogram was detected in 7 patients (53.8%), and paroxysmal slow-wave activity in 3 patients (23.1%). In subgroups, epileptiform activity was detected in 6 patients (22.2%) and paroxysmal slow-wa…
creator: Sergey N. Bazilevich
creator: Igor V. Litvinenko
creator: Nikolay V. Tsygan
creator: Miroslav M. Odinak
creator: Mikhail Y. Prokudin
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-11-07
publication date: 2025-11-07
volume: 44
number: 4
starting page: 381
ending page: 394
doi: 10.17816/rmmar690186

New approaches to spasticity management after spinal cord injury: application of multilevel magnetic stimulation
type: item
description: BACKGROUND: Each year, 5–6 million injuries involving the nervous system are reported worldwide, of which 5%–9% are spinal cord injuries. Although these occur less frequently, the outcomes are severe: up to 100% of affected individuals develop disability or die. Muscle spasticity is one of the most common complications after spinal cord injury, particularly if the cervical and upper thoracic spine is involved. Spasticity develops as a result of damage to descending pathways and loss of inhibitory cortical control. Severe spasticity substantially limits rehabilitation, contributes to contractures and pressure ulcers, reduces quality of life, and increases socioeconomic burden, highlighting the need for more effective treatment methods. AIM: This work aimed to assess the effectiveness of multilevel magnetic stimulation as a method for reducing the severity of muscle spasticity in patients with spastic mono- and paraplegia due to spinal cord injury. METHODS: A comprehensive evaluation was performed in 30 patients with spinal cord injury who were assigned to either the main group or the control group. Spasticity was assessed using the Modified Ashworth Scale. The main group received standard of care combined with multilevel magnetic stimulation, whereas the control group received standard of care alone. RESULTS: Data from 30 patients were analyzed. Four patients in the control group and three in the intervention group were excluded due to absence of spasticity. The mean Modified Ashworth Scale score decreased from 3.73 to 2.00 points in the main group and from 3.58 to 2.08 points in the control group. Although the reduction in both groups was statistically significant, clinical improvement was more pronounced when multilevel magnetic stimulation was used (Cohen’s d: 1.45 vs 0.91, respectively). Intergroup differences did not reach statistical significance, yet the effect size indicates a clear advantage of the experimental technique. The results support the feasibility …
creator: Daniil A. Solovev
creator: Vladimir Y. Lobzin
creator: Ivan A. Lupanov
creator: Daria N. Frunza
creator: Aleksandr S. Rodionov
creator: Aleksandr V. Ryabtsev
creator: Pavel S. Dynin
creator: Konstantin M. Naumov
creator: Nikolay V. Tsygan
creator: Igor V. Litvinenko
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: 2025-11-05
publication date: 2025-11-05
volume: 44
number: 4
starting page: 395
ending page: 404
doi: 10.17816/rmmar690429

Comparative effectiveness of medical care for patients with in-hospital ischemic stroke in primary stroke units and regional comprehensive stroke centers
type: item
description: BACKGROUND: In-hospital ischemic stroke is a severe competing condition associated with a high rate of adverse outcomes. AIM: This work aimed to compare the effectiveness of medical care for patients with in-hospital ischemic stroke in facilities with a primary stroke unit versus a regional comprehensive stroke center. METHODS: A retrospective analysis was performed, evaluating quality of care and outcomes in 389 patients with in-hospital ischemic stroke across 12 healthcare facilities in Saint Petersburg during 2015–2024: eight hospitals with a regional comprehensive stroke center and one federal medical organization providing 24/7 endovascular care for in-hospital ischemic stroke (n = 268); and three multidisciplinary hospitals with a primary stroke unit (n = 121). RESULTS: In-hospital ischemic stroke occurred more frequently in internal medicine patients in primary stroke units (66.9% vs 33.1%), whereas in regional comprehensive stroke centers it was more common in surgical patients (56.7% vs 43.3%; p < 0.001). Patients with in-hospital ischemic stroke treated in primary stroke units were older (77.0 ± 13.0 vs 69.0 ± 12.0 years; p < 0.001), had higher comorbidity burden by Charlson Comorbidity Index (8.9 ± 3.7 vs 7.1 ± 2.8; p < 0.001), and were more often admitted urgently (85% vs 57%; p < 0.001). In-hospital ischemic stroke in primary stroke units was associated with more severe neurological deficits (13 ± 7 vs 12 ± 8; p = 0.025), poorer functional outcomes (p < 0.001), and higher in-hospital mortality (53% vs 29%; p < 0.001) compared with regional comprehensive stroke centers. At diagnosis of in-hospital ischemic stroke, angiographic (11% vs 57%; p < 0.001) and perfusion (0.8% vs 5.4%; p < 0.001) neuroimaging studies were performed less frequently in hospitals with primary stroke units than in regional comprehensive vascular centers; emergency reperfusion methods were also used less often (0.8% vs 16.4%; p < 0.001). CONCLUSION: Differences in functional capacit…
creator: Sergey V. Kolomentsev
creator: Igor A. Voznyuk
creator: Aleksandr V. Savello
creator: Aleksandr I. Yakovlev
creator: Olga V. Rubleva
creator: Nadezhda A. Tsurikova
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-11-05
publication date: 2025-11-05
volume: 44
number: 4
starting page: 405
ending page: 414
doi: 10.17816/rmmar691578

Risk factors and differential prevention of in-hospital hemorrhagic stroke
type: item
description: In-hospital hemorrhagic stroke is a subtype of acute cerebrovascular disease of hemorrhagic origin that includes all forms of non-traumatic intracranial hemorrhage (including subarachnoid hemorrhage) occurring in patients hospitalized for diagnostic evaluation or treatment of another condition, or admitted for a diagnostic or therapeutic procedure. Unlike in-hospital ischemic stroke, the epidemiology of in-hospital hemorrhagic stroke remains insufficiently studied. In-hospital hemorrhagic stroke is a relatively rare competing condition, yet is characterized by a high rate of adverse outcomes (mortality may reach 50%), which may significantly contribute to in-hospital mortality and, similar to in-hospital ischemic stroke, is highly relevant and requires active investigation. In addition to common and specific risk factors, unique risk factors directly related to diagnostic and therapeutic procedures performed in the hospital setting play an important role in the pathogenesis of in-hospital hemorrhagic stroke. This article discusses the most frequent medical procedures associated with the highest risk of in-hospital hemorrhagic stroke, including endovascular surgical interventions, systemic thrombolytic therapy, and antithrombotic therapy. Based on the analysis of risk factors, currently relevant options for differentiated prevention are presented. Recognition of in-hospital hemorrhagic stroke as a distinct clinical condition will enable more effective targeted prevention, reduce in-hospital mortality, and improve clinical outcomes of in-hospital hemorrhagic stroke.
creator: Evgeniy I. Shermatyuk
creator: Nikolay V. Tsygan
creator: Aleksandr A. Postnov
creator: Maxim G. Chernenok
creator: Vadim A. Medvedev
creator: Tatyana V. Sergeeva
creator: Igor V. Litvinenko
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: 2025-11-07
publication date: 2025-11-07
volume: 44
number: 4
starting page: 415
ending page: 425
doi: 10.17816/rmmar677140

Acupuncture therapy in the late recovery phase of facial nerve neuropathy
type: item
description: BACKGROUND: In 10%–30% of patients, the clinical course of facial nerve neuropathy progresses to a chronic stage with only partial recovery of facial muscle function and development of complications, including synkinesis and contractures. Current treatment approaches remain insufficiently effective. AIM: To examine the clinical characteristics of facial nerve neuropathy during the late recovery period, select reflexotherapy-based treatment approaches, and assess treatment outcomes. METHODS: Thirty-four patients aged 19–80 years (mean age: 49.9 ± 12.1 years) with facial nerve neuropathy (15 men and 19 women) were examined. Patients were divided into three groups according to clinical features: group 1 (22 individuals) with compression–ischemic neuropathy; group 2 (6 individuals) with infection-mediated neuropathy; group 3 (6 individuals) with history of traumatic facial nerve injury. All patients underwent clinical and instrumental evaluation using the House–Brackmann Facial Nerve Grading Scale, the Sunnybrook Facial Grading System for assessment of severity of paresis and pathological synkinesis, and electroneuromyography. Combined treatment included a course of acupuncture with a 4-month follow-up period. RESULTS: Based on clinical neurological examination, postneuritic contractures and synkinesis were identified in all patients. Electroneuromyography demonstrated mixed severe nerve fiber damage. The Sunnybrook Facial Grading System was the most appropriate scale for assessing the trends of contractures and synkinesis. Acupuncture demonstrated clinical value for rehabilitation of patients with long-term consequences of facial nerve neuropathy. Its use enables influence on neuroplasticity processes. The reflexology method of proprioceptive stimulation developed by Shishkina enables modulation of pathological cortical processes and provides positive changes in the treatment of complications during late recovery of facial nerve neuropathy. Correction of facial nerve n…
creator: Galina O. Andreeva
creator: Miroslav M. Odinak
creator: Vladimir Y. Lobzin
creator: Elvira V. Shishkina
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-11-05
publication date: 2025-11-05
volume: 44
number: 4
starting page: 427
ending page: 434
doi: 10.17816/rmmar690504

Key risk factors and a prognostic model for vascular myelopathy
type: item
description: BACKGROUND: Vascular myelopathy remains diagnostically challenging due to its polymorphic clinical presentation and the lack of clear differential diagnostic criteria, which leads to delayed diagnosis and worse outcomes. Although vascular risk factors are known to contribute to this condition, their combined interaction and relative contribution to spinal cord infarction are insufficiently understood. AIM: This work aimed to systematize known and newly identified clinically significant risk factors for ischemic spinal cord injury and to develop a prognostic model of vascular myelopathy. METHODS: A prospective and retrospective cohort study included 177 patients, divided into a spinal cord infarction group (n = 77) and a comparison group with other acute and subacute myelopathies (n = 100). Inclusion criteria were clinical and instrumental signs of myelopathy confirmed by magnetic resonance imaging, with subsequent stratification by etiology. The primary endpoint was identification of independent predictors of vascular spinal cord injury using multivariate logistic regression analysis. RESULTS: Significant between-group differences were found in favor of the main group regarding atherosclerosis (75.3% vs 22.0%, p < 0.0001), aortic condition (50.6% vs 7.0%, p < 0.0001), hypercoagulable states (26.0% vs 2.0%, p < 0.0001), spinal cord arteriovenous malformations (20.8% vs 3.0%, p = 0.0002), and iatrogenic interventions (18.2% vs 3.0%, p = 0.001). Multivariate analysis identified four independent predictors of vascular myelopathy: aortic condition (OR = 28.1), thrombophilia (OR = 36.4), venous anomalies (OR = 21.4), and uncomplicated spinal trauma (OR = 11). These formed a prognostic model with AUC = 0.88, sensitivity of 87.0%, and specificity of 84.0%. CONCLUSION: This study confirms the key role of macrovascular and thrombophilic factors in the pathogenesis of vascular myelopathy and proposes a clinically significant prognostic model for early diagnosis of this conditi…
creator: Grigory V. Ponomarev
creator: Aleksandr V. Amelin
creator: Aleksandr A. Skoromets
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: 2025-11-05
publication date: 2025-11-05
volume: 44
number: 4
starting page: 435
ending page: 443
doi: 10.17816/rmmar688474

Comorbidity and differential diagnosis of idiopathic normal pressure hydrocephalus and Alzheimer disease
type: item
description: BACKGROUND: The progression of intellectual and memory impairment is a pressing public health challenge and often leads to disability in older adults. Idiopathic normal pressure hydrocephalus represents one of the causes of dementia and is frequently comorbid with neurodegenerative disorders, particularly Alzheimer disease. Such comorbidity substantially complicates differential diagnosis. Therefore, the search of diagnostic algorithms that allow clinicians to address this problem is essential. AIM: This work aimed to improve the diagnostic accuracy of idiopathic normal pressure hydrocephalus, Alzheimer disease, and their combination by applying a comprehensive clinical, neuropsychological, laboratory, and neuroimaging assessment. METHODS: All patients (171 individuals) were divided into groups according to the disease. All subjects underwent extended neuropsychological testing, gait assessment using standardized scales, neuroimaging interpretation using neuroradiological scales, and cerebrospinal fluid biomarker assay of amyloidogenic and tau-pathology–related proteins. RESULTS: Patients with normal pressure hydrocephalus demonstrated a predominantly dysregulatory cognitive impairment pattern, whereas memory impairment was secondary. In the combined Alzheimer disease–idiopathic normal pressure hydrocephalus syndrome, both dysregulatory and amnestic patterns coexisted (with the amnestic component predominating). Markedly reduced gait speed was a highly sensitive marker of idiopathic normal pressure hydrocephalus. Patients with the comorbidity also demonstrated reduced gait speed, although to a lesser degree. Cerebrospinal fluid biomarker profile in normal pressure hydrocephalus was characterized by reduced tau and phosphorylated tau levels with normal β-amyloid. In contrast, comorbid patients demonstrated reduced β-amyloid and increased tau and phosphorylated tau concentrations. Neuroimaging analysis revealed that idiopathic normal pressure hydrocephalus is characte…
creator: Anna V. Smolyannikova
creator: Vladimir Y. Lobzin
creator: Andrey Y. Emelin
creator: Gaspar V. Gavrilov
creator: Kristina A. Kolmakova
creator: Igor V. Litvinenko
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: 2025-11-05
publication date: 2025-11-05
volume: 44
number: 4
starting page: 445
ending page: 454
doi: 10.17816/rmmar690457

Event III. Eastern medicine in Russia. The 21st century. Contemporary directions of the Leningrad–St. Petersburg school
type: item
description: This article continues the series of publications devoted to the origins, formation, and development of Eastern medicine in Russia. The first two works covered the period from the initial introduction of philosophical concepts and health practices of Chinese medicine into Russian medical science and practice in the 18th–19th centuries, to the official recognition of reflexotherapy and other modalities of Chinese medicine as full components of Soviet and post-Soviet healthcare in the late 20th century — along with the establishment of Soviet scientific schools in Leningrad–St. Petersburg. The third part examines the further evolution of Chinese medicine traditions within contemporary St. Petersburg medical areas, including the emergence of specialized departments in leading medical universities of the city, major achievements, and research projects of key experts in this field. Methods of traditional Chinese medicine are being increasingly applied in medical practice, becoming part of broader rehabilitation, preventive, and therapeutic programs following illnesses and surgical interventions. In this context, returning to the historical origins of this ancient medical knowledge in Russia — and studying its dissemination, institutionalization, integration into Russian educational curricula, methodological guidelines, and clinical practice recommendations — remains highly relevant. Another important task is the expansion of scientific research in the field of reflexotherapy based on accumulated experimental and clinical evidence.
creator: Galina O. Andreeva
creator: Miroslav M. Odinak
creator: Vasiliy N. Tsygan
creator: Igor V. Litvinenko
creator: Svetlana A. Mamaeva
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-11-05
publication date: 2025-11-05
volume: 44
number: 4
starting page: 455
ending page: 463
doi: 10.17816/rmmar690440

Molecular epidemiology of malaria vector mosquitoes in coastal areas of Southern Vietnam
type: item
description: BACKGROUND: This study presents the results of morphological genus-level identification of mosquitoes and molecular-genetic species-level identification of female Anopheles mosquitoes — the primary malaria vectors — collected in the Can Gio Biosphere Reserve, Ho Chi Minh Province. In addition, five species of human malaria parasites of the genus Plasmodium (P. falciparum, P. vivax, P. ovale, P. malariae, and P. knowlesi) were screened in the collected material. AIM: To assess the species composition of vectors responsible for the most relevant and socially significant vector-borne infections in southern Vietnam during the dry and rainy seasons, and to identify active malaria foci. METHODS: Arthropod collection was carried out in October 2024 and May 2025 in the Can Gio Biosphere Reserve (Ho Chi Minh Province). Adult hematophagous dipterans were collected using aspirators from hosts, entomological nets from vegetation, as well as from external surfaces of residential and utility buildings. Immature stages were collected by filtering water samples from natural and artificial water bodies suitable for mosquito breeding. Species identification of arthropods was performed based on morphological characteristics using dichotomous keys. Mosquito species identification and Plasmodium detection were conducted using polymerase chain reaction (PCR). Confirmation of Plasmodium ovale was performed by Sanger sequencing. RESULTS: A total of 414 Anopheles mosquitoes were identified, of which 356 specimens (86%) belonged to An. epiroticus. DNA of Plasmodium parasites was detected in 32 mosquito samples: 17 (53.1%) positive for P. falciparum and 15 (46.9%) for P. ovale. CONCLUSION: Despite a general decline in malaria incidence in Vietnam, foci of “forest malaria” remain active. In coastal areas of southern Vietnam, An. epiroticus plays an important role in maintaining active malaria transmission. In addition to spreading the causative agent of tropical malaria (P. falciparum), these …
creator: Mo Thi Luong
creator: Vladimir A. Romanenko
creator: Aleksei I. Solovyev
creator: Roman V. Gudkov
creator: Konstantin V. Kozlov
creator: Dmitrii V. Ovchinnikov
creator: Aleksandr I. Rakin
creator: Alexey V. Khalin
creator: Sergey V. Aybulatov
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: 2025-11-05
publication date: 2025-11-05
volume: 44
number: 4
starting page: 465
ending page: 473
doi: 10.17816/rmmar691276

Current concept of gastroesophageal reflux disease: a review
type: item
description: Gastroesophageal reflux disease remains one of the most pressing issues in modern gastroenterology due to its high prevalence, chronic course, and risk of severe complications, including Barrett esophagus. This review summarizes research published between 2014 and 2024 in international (PubMed, Web of Science) and Russian (Russian Science Citation Index) scientific databases addressing epidemiology, pathophysiology, and treatment of gastroesophageal reflux disease. Epidemiological data demonstrate a global increase in disease burden—from 442 million cases in 1990 to 784 million in 2019—with marked regional variability (from 2.5% in China to 45.4% in the Middle East). In the Russian Federation, gastroesophageal reflux disease prevalence reaches 25.6%, with the highest rates observed in individuals older than 50 years. Key risk factors include abdominal obesity, tobacco smoking, and use of nonsteroidal anti-inflammatory drugs. Management of gastroesophageal reflux disease includes both non-pharmacologic approaches (lifestyle modification, diet therapy, breathing exercises) and pharmacotherapy. Proton pump inhibitors remain the standard of care; however, their long-term use is associated with risk of adverse effects. Promising areas include combination regimens incorporating antacids, alginates, esophagoprotective agents, and novel potassium-competitive acid blockers, which demonstrate advantages in treatment of resistant gastroesophageal reflux disease. Special attention is given to non-pharmacologic treatment strategies. Optimization of pharmaceutical counseling remains an important challenge aimed at minimizing self-medication and improving treatment adherence. The findings underscore the need to develop personalized therapeutic strategies considering clinical heterogeneity of gastroesophageal reflux disease, as well as the incorporation of innovative methods into clinical practice. Review results confirm the importance of a multidisciplinary approach to reduce heal…
creator: Kseniya S. Biryukova
creator: Dilyara K. Shakirova
creator: Yuri V. Miroshnichenko
creator: Aleksandr B. Perfilyev
creator: Sayar R. Abdulkhakov
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-11-07
publication date: 2025-11-07
volume: 44
number: 4
starting page: 475
ending page: 484
doi: 10.17816/rmmar678881

On methods of blood pressure measurement: to 120th anniversary of N.S. Korotkoff’s discovery
type: item
description: This study presents a comprehensive historical and scientific analysis of the evolution of blood pressure measurement methods, dedicated to the 120th anniversary of the fundamental discovery made by Russian physician Nikolai S. Korotkoff. In 1905, he introduced the auscultatory method, which became a turning point in the development of cardiology and general medical diagnostics. The work covers more than two centuries of scientific progress—from the first invasive experiments by Stephen Hales in the 18th century, when blood pressure measurement required direct vascular access in animals, through the fundamental contributions by Bernoulli and Poiseuille that established the theoretical basis for understanding blood flow, to the development of the first non-invasive sphygmomanometers in the 19th century. Special attention is given to the contributions by Vierordt, Marey, and Riva-Rocci, whose developments created the technological foundation for Korotkoff’s discovery. A central part of this study is devoted to the detailed analysis of the revolutionary auscultatory method, which was initially met with skepticism by the medical society, but due to its simplicity, accuracy, and reproducibility, rapidly gained worldwide recognition and became the gold standard in clinical practice. From a modern scientific standpoint, the hemodynamic and biomechanical basis of Korotkoff sounds is described, explaining the physical nature of their appearance related to the transition of blood flow from laminar to turbulent during gradual arterial decompression. Advantages and limitations of the method are analyzed, considering it not only as a historical phenomenon but also as a current diagnostic tool retaining relevance in contemporary medicine. Particular emphasis is placed on the influence of the Korotkoff method on subsequent technologies for blood pressure measurement, including the oscillometric method, which dominates modern automatic and semi-automatic blood pressure meters but s…
creator: Aleksandr E. Korovin
creator: Ivan D. Nemeshev
creator: Dmitriy V. Ovchinnikov
creator: Maria V. Polyanichko
creator: Sergey V. Mylnikov
creator: Leonid P. Churilov
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: 2025-11-05
publication date: 2025-11-05
volume: 44
number: 4
starting page: 485
ending page: 493
doi: 10.17816/rmmar693531

Mirror-image type III complete duplication of inferior vena cava: a distinct classification subtype or a variant of an existing one?
type: item
description: The article presents a case of duplication of the inferior vena cava detected as an incidental finding in a 62-year-old patient who underwent computed tomography of the chest and abdomen for rectal cancer. Imaging revealed duplication of the inferior vena cava, with the left trunk exceeding both the right trunk and the aorta-crossing trunk in diameter. Both trunks were formed by anastomosing common iliac veins. Duplication of the left renal artery and vein was also noted; the lower left renal vein drained directly into the left trunk of the inferior vena cava, which then joined the upper renal vein and crossed the aorta as a single trunk before merging with the right inferior vena cava. The further course of the inferior vena cava to the right atrium was anatomically normal. The currently existing classification of inferior vena cava duplication does not provide a definitive description for the variant identified in this patient, creating difficulty in formulation of the medical conclusion. The observed anatomy most closely corresponded to Type III duplication, in which the right trunk normally exceeds the left and the aorta-crossing trunk in diameter. Based on the radiologic features and morphometric measurements of the duplicated inferior vena cava trunks, we assume that this represents a rare mirror-image anatomic variant of Type III duplication, in which the left trunk has the greatest diameter. Scientific data review revealed two additional reports describing similar duplication cases (three previously reported patients in total). In one publication this variant was suggested as a Type IV duplication, whereas in another, classification was not provided. Whether this anatomical pattern should be considered an independent Type IV duplication or a mirror-image modification of Type III remains debatable and merits discussion from an anatomical nomenclature standpoint. However, larger patient samples would be required, which is challenging owing to the rarity of the…
creator: Stanislav V. Shershnev
creator: Ekaterina I. Yudina
creator: Victor V. Ipatov
creator: Aleksey A. Semenov
creator: Valentina A. Cheprakova
creator: Ornella D. Khugaeva
creator: Ruslan Z. Sutatov
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-11-05
publication date: 2025-11-05
volume: 44
number: 4
starting page: 495
ending page: 502
doi: 10.17816/rmmar677068