[The analysis of state of system of training of first medical aid to professional contingents of the Ministry of Emergency Situations].

The article considers issues of training and motivation of first aid personnel whose duties are to provide it in accordance with Federal law. This category of personnel includes employees who received appropriate training, including military personnel and employees of State Fire Service, rescue units and rescue services staff. The results of analysis of training of emergency personnel in first aid demonstrates that level of first aid skills of these categories of personnel is different. Also it was established inconsistency of training programs with uniform standards. The conclusion is made that it is necessary to bring training to single standard and to introduce systematic approach to first aid training of this categories of personnel.

Intraosseous injections of platelet rich plasma for knee bone marrow lesions treatment: one year follow-up.

PURPOSE: Cartilage lesions are usually accompanied by subchondral bone alterations or bone marrow lesions (BMLs). BML associated with joint degeneration and cartilage lesions are considered to be predictors of rapidly progressing OA. Currently no existing treatment can fully halt OA progression. One of the approaches is an autologous, biological treatment based on the use of platelet rich plasma (PRP) injections. The purpose of this study is to assess the short-term effectiveness of intraosseous PRP injections, within the BML of individuals affected by OA, in ameliorating pain and improving knee functionality. MATERIALS AND METHODS: The study involved 17 patients with an average age of 41.7 ± 14.3 years old. OA stage was determined using the Kellgren-Lawrence grading system by performing radiographic scanning of the knee joint before surgical intervention. Patients with K-L grade 3 knee joint OA prevailed. Patient OA history varied between one and nine years (average 5.2 ± 4.5 years). Clinical and functional state of the knee were assessed by pain visual analogue scale (VAS) score, the Western Ontario and McMaster Universities Score (WOMAC), and the Knee Injury and Osteoarthritis Outcome Score (KOOS) which were filled out by patients previous to the surgical procedure at one, three, six and 12 months post-operatively. Before surgery, in addition to standard blood tests, serum cartilage oligomeric matrix protein (COMP) levels were tested for all patients. RESULTS: Evaluation of preliminary results revealed a statistically significant reduction of pain based on the VAS score. A significant improvement was also observed in the patients' WOMAC score and in the overall KOOS score. Serum marker levels were initially elevated in our experimental patient group compared to the same marker in healthy control respondents, and continued to rise one month and three months following surgery, at six and 12 month the level was similar as at three months. CONCLUSIONS: In our opinion, first COMP increasing can be caused by injection of platelet rich plasma. It is not adequate to interpret this growth in COMP levels as increased osteochondral degeneration. One year follow-up period showed good quality of life improvement, significant pain reduction, and essential MRI changes. The long-term observation of these cohort of patients combined with an analysis of MRI images is still ongoing.

[Reconstructive operations on soft tissues in the treatment of bedsores in patients with spinal injuries]. / Rekonstruktivnye operatsii na miagkikh tkaniakh pri lechenii vertikal'nykh prolezhnei u spinal'nykh bol'nykh.

The paper presents the results of plastic operations on 54 trochanterian bedsores in 48 patients with complicated spinal injury. Early positive results were obtained in 100% of cases when various modifications of a skin-subcutaneous flap was applied in 16 patients with 17 bedsores. There were relapses in 4 patients following a year. A full-layer skin-subcutaneous-fasciomuscular flap was employed in 33 patients with 37 bedsores. A poor result, namely flap non-acceptance, was seen in one case. Late relapses were absent. It is most expedient to use full-layer flaps in the treatment of bedsores in the tronchaterian area in terms of its anatomic features.

[Treatment of suppurative-necrotic decubitus ulcers in patients with spinal injuries by using alginate coating teralgim and algimaf]. / Lechenie gnoino-nekroticheskikh prolezhnei u spinal'nykh bol'nykh s primeneniem al'ginatnykh pokrytii "teral'gim" i"al'gimaf".

Alginate coating teralgim and algimaf were applied to 24 decubitus ulcers of various sites in 19 spinal patients. Stage--specific choice of applications produced a good cleansing effect and ulcer healing in 62.5% of the lesions within 48.5 days on the average. Indications for surgery were defined in 37.5% of the cases (repair of the ulcer defect) which were also treated with alginate coating with a good preoperative effect.

[Treatment of decubitus ulcer by "Algimaf" preparation]. / Lechenie prolezhnei s primeneniem preparata "Algimaf".

The process of treatment of 20 spinal patients with 26 decubituses of different localization by means of applications of alginatous coating "Alghimaf" has been observed. The results of treatment are as follows: 22 wounds healed with formation of soft elastic cicatrix, 2 patients have been discharged from hospital with actively epithelializing wounds, 2 patients were subjected to epidermatoplasty. The method of control: chnic observation, planimetry, citologic, microbiologic investigations. It has been demonstrated "Alghimaf" efficiency in treating of decubituses.