[The nature of postoperative complications in patients with peritonitis].

We studied the postoperative period in patients with peritonitis. The structure of the most important factors that slow down the healing process and lead to mortality. Among the factors that affect the healing process is the most important character of fluid, and the prevalence of peritonitis (causative factor), which causes complications on the part of the internal organs and wounds.

[Changes of humoral immunity in patients operated for peritonitis].

The inflammation process course as well as probability of complications occurrence are determined by changes in humoral link of immunity. Positive dynamics of humoral component of the immune answer was trustworthy proved in patients, suffering local peritonitis, what have had witnessed the presence of an active and adequate function of the immune system, which was able to localize the inflammation process. In such course of the disease it is not necessary to conduct additional immune correction. Unfavourable immune profile and its dynamics in patients, suffering diffuse and spreaded peritonitis are determined by the quantity lowering of CD22 without its enhancement on the 3 - 7 day; low level of IgG in conjunction with high level of IgA and IgM (so called "scissors"), what do not change on the 3 - 7 day. The tendency of the IgG level lowering during the treatment constitute an urgent indication for the restorative therapy conduction, using immunoglobulins.

[Changes in cellular immunity in patients operated for peritonitis].

While estimating a cellular immunity state in patients, suffering peritonitis, there was established dependence of immunological changes from severity of its course. While presence of a local peritonitis a cellular link of immunity changes the least and restores adequately in 3-7 days, what constitute a positive prognostic sign and impacts a clinical course of the disease. While an adequate immune reaction is present, the patients reconvalescence accelerates. In a diffuse peritonitis the changes are more pronounced, especially on the third day, but a tendency towards their improvement on the 7-th day of treatment is noted. For an effective treatment of such patients immunocorrecting preparations must be applied, beginning from a 2 - 3-d days, choosed by physician. Largest changes in the immunity cellular link were revealed in patients with over flow peritonitis, they persisted or worsened on the 7-th day, caused a severe course of the disease and complications occurrence. For such patients the immunocorrecting therapy must be administered right from the treatment beginning.

[Delivery of health care at second and tertiary level from economic point of view].

Economical issues related to medical care at second and tertiary level and some ways of their resolution were discussed in the article.

[Economic approach to providing medical care in rural areas].

Some issues of economical aprroach in providing medical care in rural area are concerned in the article. Economical principles are expressed to be essential in this field of medicine.