Bulletin of RSMU

ISSN Print 2500–1094 ISSN Online 2542–1204

Bulletin of RSMU

BIOMEDICAL JOURNAL OF PIROGOV UNIVERSITY (MOSCOW, RUSSIA)

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Arinin FR, Naranov UA, Politaeva PV, Likhovets ES, Fedoreeva LA, Kopyl EV, Nabieva TD, Kutsenko EV, Rustamova AR

Here we present a rare case of inflammation in the Meckel's diverticulum with the ectopic pancreatic tissue in a 18-year-old patient. Laparoscopy converted to laparotomy was performed. The inflamed Meckel's diverticulum was found during intraoperative revision, which was the reason to perform segmental resection of the affected area of the small intestine with the construction of an enteroenteric anastomosis. Pathological examination of surgical material revealed mature exocrine tissue of the pancreas without any signs of cellular atypia, which confirmed the presence of pancreatic heterotopia in the Meckel's diverticulum. The reported case demonstrates rarity of such combination of abnormalities, highlights diagnostic difficulties at the preoperative stage, and draws attention to the need for thorough intraoperative revision of the small intestine, as well as for mandatory morphological verification to establish the final diagnosis and determine further patient management tactics.

Received: 2026-04-09

Published online: 2026-05-24

DOI: 10.24075/brsmu.2026.024

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VIEWS 20

Olkova MV, Koshel SM, Ponomarev GYu, Alimov AA

The exploration of ATM gene haplotype evolutionary variability and its geographic dissemination across Eurasia enables the utilization of these data to predict the distribution of diseases associated with alleles comprising these haplotypes. The study aimed to identify the ATM gene haplotypes unique to Eurasia based on the panel of 28 polymorphic loci determining two major “yin-yang” haplotypes. The analysis was conducted using individual genotype data for 28 ATM gene loci across 41 groups of indigenous Eurasian populations. Haplotypes were identified using the Haploview 4.1 software. Phylogenetic analysis was performed in RStudio using the pegas and geneHapR packages. Cartographic visualization of ATM haplotype frequencies was implemented using the GeneGeo cartographic package. The H7j haplotype was identified in indigenous peoples of North Eurasia, which suggests its localized origin. The maximum H7i frequency was reported for Finno-Ugric peoples of the north and indigenous peoples of the northern Eurasia. The highest H8j haplotype frequency is observed in populations of southern China and Japan, which probably indicates the place of its origin. The remaining haplotypes are rare, these are typical for small geographic regions: H6j is sporadically distributed across Asia, H8i is localized to Transcaucasia, and H9i is found in two meta-groups of Eastern European peoples. The data obtained suggest the presence of the ATM gene haplotypes specific for the population of Eurasia, emphasize the contribution of intragenic recombination in shaping the gene haplotype diversity, and highlight the importance of the geographic and demographic context for preservation and spread of distinct genetic variants.

Received: 2026-04-03

Published online: 2026-05-23

DOI: 10.24075/brsmu.2026.023

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VIEWS 57

Mrikaeva OM, Akhmatova FT, Kakaeva MR, Rasukhanova EU, Elmurzaev SS-Kh, Dzhabrailov BKh, Yusupova ST, Tugueva SL, Idrisova SM

Rapid palatal expansion may affect not only maxillary dimensions but also upper airway patency in adolescents; however, the role of tooth-supported and miniscrewassisted appliances remains to be clarified. This study aimed to assess morphological and functional changes in the upper respiratory tract associated with rapid palatal expansion and to compare these changes between the use of Hyrax and MARPE systems. We conducted a prospective pilot study involving 24 adolescents aged 12–16 years with transverse maxillary insufficiency. Fourteen participants received Hyrax appliances, while ten received MARPE devices. Time points: T0 — before treatment, T1 — 6 months after completion of activation. The measured indicators were the volume of the nasal cavity, nasopharynx, and oropharynx, the minimum area of the retropalatal level, and the total nasal resistance at 150 Pa. We also calculated the NOSE score. After treatment, the volume of the nasal cavity increased by 14.6% (p < 0.001), nasopharyngeal volume by 8.9% (p = 0.003), the minimum area of the retropalatal level by 12.1% (p = 0.012), total nasal resistance decreased by 24.7% (p < 0.001), and NOSE score by 35.4 points (p < 0.001). The change in oropharyngeal volume was insignificant (p = 0.091). We established no differences between Hyrax and MARPE groups (p > 0.05). Rapid palatal expansion improved nasal cavity and nasopharynx parameters. Further comparisons of techniques require a priori sample size calculations.

Received: 2026-03-19

Published online: 2026-05-18

DOI: 10.24075/brsmu.2026.022

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VIEWS 155

Demin NA, Achkasov EE, Polyaev BA, Shishkin AA, Medvedeva AI, Ostanin OE

High prevalence of postoperative ventral hernias necessitates the development of effective rehabilitation protocols to restore abdominal muscle function early and reduce recurrence risk. This study aimed to evaluate the effects of electromyostimulation (EMS) of the anterior abdominal wall muscles on physical activity levels and strength performance in patients after surgical treatment for postoperative ventral hernias. We enrolled 128 patients (mean age, 47.9 ± 8.6 years) who underwent open combined component separation surgery with retromuscular mesh implantation. In the treatment group (n = 64), the course of anterior abdominal wall EMS (enabled by COMPEX SP-2.0) started on the 10th day after surgery; in the control group (n = 64), we followed a standard post-surgery protocol. The assessed indicators were the level of physical activity (pedometry, 7 days) and the strength of the trunk muscles (strain dynamometry, registered with a BackCheck 700 device). Six months after surgery, the EMS group showed significantly greater muscle strength gains than the control group: in trunk extension, median strength was 26.9 kg versus 15.4 kg (74.7% increase; p < 0.001); in flexion, it was 15.7 kg versus 8.0 kg (96.3% increase; p < 0.001). The level of physical activity in the EMS group was significantly higher: the median number of steps per week was 27304.5 ± 2903.48 (95% CI 20964.6–33644.5), while in the control group it reached 11173.6 ± 3688.8 (95% CI 10065.4–12281.9) steps. This indicates a recovery to 90.0% of the preoperative level. Thus, an early post-surgery course of EMS of the anterior abdominal wall muscles is an effective rehabilitation method that significantly improves the strength characteristics of the core muscles and restores the levels of physical activity in patients.

Received: 2026-03-29

Published online: 2026-05-13

DOI: 10.24075/brsmu.2026.021

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VIEWS 164

Demin NA, Achkasov EE, Polyaev BA, Shishkin AA, Medvedeva AI, Ostanin OE

Muscular dysfunction of the anterior abdominal wall persists in many patients post component separation due to postoperative ventral hernia. Electrical myostimulation can contribute to better recovery, but its efficacy after such surgical procedures is poorly understood. The study aimed to assess the effect of the postoperative electrical myostimulation on the neuromuscular conduction and functional activity of the rectus abdominis muscles. A total of 128 patients (average age 47.9 ± 8.6 years) post component separation were included in a prospective controlled non-randomized study. The index group (n = 64) received electrical myostimulation starting from day 10 (12 sessions, 5–10 min each, 3 times a week, COMPEX SP-2.0® muscle stimulator, Switzerland), and the control one (n = 64) received no electrical myostimulation. Electroneuromyography of the rectus abdominis muscles was performed before and after the course using the Synapsis system (Neurotech, Russia). In the index group, the latency period reduced from 10.1 to 7.9 ms (by 21.8%; p < 0.001), and in the control group it reduced from 9.7 to 9.2 ms (by 5.2%; p < 0.001); the intergroup difference p = 0.002. The M-response amplitude improved in both groups (index group: from 8.4 to 8.9 mV, +5.6%, p < 0.001; control group: from 8.2 to 8.8 mV, +6.8%, p < 0.001), without any intergroup differences (p = 0.295). The induced muscle contraction velocity changed minimally in the index group (from 45.0 to 45.4 m/s, p = 0.049) and did not change in the control group (p = 0.316); in 89.1% of patients, the values were still below normal. Conclusions: postoperative electrical myostimulation significantly accelerates the neuromuscular conduction restoration, but does not affect the muscular response amplitude. It is reasonable to include electrical myostimulation in rehabilitation programmes.

Received: 2026-03-29

Published online: 2026-04-28

DOI: 10.24075/brsmu.2026.020

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VIEWS 240

Dzaraeva ZR, Dulaeva AA, Dudaeva LR, Makieva KA, Tsakhilova ZS, Alakhverdieva SS, Sagilaeva KhM, Kurmagomedov MA, Dzhafarov UL

Type 2 diabetes mellitus (T2D) and obesity enhance systemic inflammation, microcirculation and immune disorders, which can make the course of chronic generalized periodontitis more severe. Comparative assessment of clinical and radiological manifestations of the disease in individuals with these conditions is important for interdisciplinary management of patients. The study aimed to conduct comparative assessment of clinical and radiological manifestations of chronic generalized periodontitis (CGP) in obese patients with T2D and those having no somatic disorders. A total of 90 patients with moderate CGP aged 35–60 were assessed, who were stratified into three groups (30 individuals per group) matched for gender and age: without any somatic disorders, with T2D and obesity. OHI-S, SBI, periodontal pocket depth (PPD), сlinical attachment loss (CAL), and radiological signs of bone resorption were assessed; the analysis of correlations with HbA1c, BMI, and lipid profile was conducted. OHI-S was 1.8 ± 0.3 in group I, 2.3 ± 0.4 in group II, and 2.2 ± 0.5 in group III; SBI was 42 ± 9%, 61 ± 11%, and 56 ± 10%, respectively (p < 0.05 for groups II and III compared to group I). PPD and CAL were higher in obese patients with T2D, than in patients having no somatic disorders (p < 0.05), while the differences between groups II and III were non-significant (for PPD p = 0.09). HbA1c levels were correlated to PPD (r = 0.42), CAL (r = 0.39), and SBI (r = 0.36); BMI was correlated to PPD (r = 0.33) and SBI (r = 0.35) (p < 0.05). Thus, T2D and obesity are associated with the more adverse clinical and radiological manifestations of CGP; it is necessary to consider poorer oral hygiene in patients with comorbidities when interpreting intergroup differences.

Received: 2026-03-19

Published online: 2026-04-28

DOI: 10.24075/brsmu.2026.019

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VIEWS 292

Minasov BSh, Yakupov RR, Akbashev VN, Bilyalov AR, Evgrafov IO, Karimov KK, Minasov IB, Akhmeldinova AA, Salimyanova MR

A chronic periprosthetic infection after knee replacement typically requires two-stage treatment. However, the inter-stage rehabilitation protocol for patients with an articulating spacer has not been adequately developed. This study aimed to determine whether adding interactive biofeedback walking training on the Walker View treadmill enhances the effectiveness of a standard recovery program following the first stage of two-stage revision treatment. The prospective randomized controlled trial included 87 patients who had undergone removal of their endoprostheses and placement of articulating spacers. The treatment group (n = 43) had the standard 21-day rehabilitation program combined with Walker View sessions, while the control group (n = 44) only followed the program. We assessed knee joint movement volume, quadriceps EMG amplitude, stride length, walking speed, postural stability, and SF-36, WOMAC, and KSS scores. By the end of the rehabilitation course, the results registered in the treatment group were better than in the control group: flexion — 78 ± 6° versus 71 ± 7° (p = 0.01); EMG amplitude — 179 ± 16 versus 165 ± 16 μV (p = 0.01); step length — 54.2 ± 5.0 versus 49.5 ± 5.0 cm (p = 0.01); walking speed — 0.70 ± 0.05 versus 0.65 ± 0.05 m/s (p = 0.02); overall stability — 80 ± 8% versus 72 ± 7% (p = 0.01); physical component SF-36 — 51 ± 8 versus 47 ± 7 points (p = 0.01). The differences in WOMAC and KSS scores were insignificant (p = 0.06 and p = 0.07). The inclusion of Walker View sessions in the inter-stage rehabilitation program yields more pronounced improvements in mobility, neuromuscular function, walking, and balance restoration.

Received: 2026-03-21

Published online: 2026-04-27

DOI: 10.24075/brsmu.2026.018

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VIEWS 215

Akkalaev AB, Abdullaeva RR, Aliev MR, Mustafaev RG, Bedoeva AA, Mironova AA, Khugaeva VF, Kadieva LM, Munapova KKh

Systemic osteoporosis is one of the most significant systemic factors capable of worsening bone tissue quality and affect osseointegration of dental implants. The increase in the number of patients of older age groups in need of implant treatment determines high clinical significance of preoperative assessment of the implant bed condition in this category of patients. The study aimed to assess clinical and morphological features of bone tissue in the dental implantation zone in patients with osteoporosis and determine the correlation of those with the primary stability of implants and early marginal bone remodeling. A total of 84 patients aged 55–75 were included in a prospective pilot study, who were planned for implantation in the areas of maxillar and mandibular premolars and molars: 42 with the confirmed systemic osteoporosis and 42 having no signs of osteoporosis. All the patients underwent CBCT with the bone quality and type determination in accordance with the Lekholm and Zarb classification; histological and histo-morphometric analysis of bone biopsy specimens was performed in a subgroup of 32 patients. Primary stability was assessed by the resonance frequency analysis; clinical monitoring was conducted after 2, 6, and 12 months. The D3–D4 type bones were more often found in patients with osteoporosis, along with lower bone density and implant stability quotient (ISQ) values, reduced bone volume fraction (BV/TV), trabecular thinning, and increased RANKL/OPG ratio. There was a positive correlation between the BV/TV, radiological bone density, and primary stability of implants. Systemic osteoporosis degrades the implant bed quality, therefore, the implantation protocol personalization and comprehensive preoperative assessment are required.

Received: 2026-03-19

Published online: 2026-04-25

DOI: 10.24075/brsmu.2026.017

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VIEWS 229