[Optimization of antisecretory component of severe acute pancreatitis intensive management].

AIM: Improvement of complex intensive care of severe acute pancreatitis with use of continued intravenous infusion of octreotid. METHODS: 85 patients with severe acute pancreatitis were involved into the investigation, were divided into 2 groups. Patients of the control group (44 patients) got an intensive care according to severe acute pancreatitis treatment. Complex intensive treatment of the group of comparison (41 patients) included injections of octreotid (300 mcg 3 times a day). RESULTS: The change of octreotid usege scheme allowed to improve treatment resultes, wchis is the decrease of endotoxemia level and minimization of time spent at emergency department.

[Prognosis and intensive care for massive obstetric blood loss].

The study covered 235 obstetric patients having varying blood loss (1.8 to 55.7%) at labor. Their constitutional, history, clinical, functional, and biochemical data were studied, which allowed the authors to develop a strategic and tactic line of prediction of the development of massive blood loss at labor. The algorithm of preventive intensive care, developed on the basis of predictive criteria, was found to significantly improve the results of treatment and to reduce the frequency and severity of obstetric hemorrhagic complications.

[Problems in emergency care for concomitant injury in the Saratov region].

The paper deals with the topical problem in emergency care delivered to patients with severe concomitant injury at its all stages (prehospital, hospital, and interhospital transportation ones). The authors analyze the activities of anesthesiological-and-resuscitative units of therapeutic-and-prophylactic facilities in Saratov and its region from 1993 to 2003. The paper presents principal schemes of delivering emergency care in severe concomitant injury and considers the problems (material, logistic, professional, and organizational) hampering the delivery of emergency care, interhospital transportation, and the rendering of various medical aids at different-leveled hospitals. The authors propose possible ways of their solution, which may ensure the timeliness of medical aid delivered to patients with severe concomitant injury, improve its quality, reduce mortality and disability rates in the patients.

[Psychoemotional status of patients with endogenous intoxication in peritonitis]. / Psikhoémotsional'nyi status bol'nykh s éndogennoi intoxikatsiei pri peritonite.

While holding a complex neuropsychological testing of 60 patients with disseminated peritonitis, we encountered a problem of a secondary reactive somatopsychosis due to metabolic encephalopathy. It is noteworthy, that the severity of psychoemotional disorders expectedly progressed depending on a degree of endogenous intoxication. Such circumstance must be duly considered in composing and implementing an intensive care scheme for the discussed patients' category.

[Acute multiple organ dysfunction syndrome in peritonitis]. / Sindrom ostroi polisistemnoi disfunktsii pri peritonite.

The laws of logic and logical research methods were made use of to assess the already published definitions of "polyorgan insufficiency" and "systemic inflammatory response". Many of them were proven to be far from being perfect; hence, the authors' independent understanding of such notions was suggested.

[Cerebral homeostasis disorder in patients with severe craniocerebral trauma during acute period]. / Narushenie komponentov tserebral'nogo gomeostaza u bol'nykh v ostrom periode tiazheloi cherepno-mozgovoi travmy.

Liquor distension, disorders of the cerebral hemodynamics as well as vegetative disorders and changes of immune reactivity in patients after a severe craniocerebral trauma are discussed. The examination of patients during the initial 10 days after trauma pointed at the relation of a cerebral trauma type with liquor distension, cerebral perfusion pressure, changes of the vegetative balance and with disorders of the auto-immune status. The most profound changes were observed in a severe craniocerebral trauma involving a severe cerebral contusion and compression.

[Immune status in the perioperative period in gestosis]. / Sostoianie immuniteta v perioperatsionnom periode pri gestoze.

Search for new methods for the earliest possible diagnosis of pre-eclampsia for timely purposeful correction of the consequences of developing disorders remains the central problem of obstetrics. We evaluated the viability of some organs by measuring specific antibody titers. The study was carried out in healthy women and patients with severe gestosis. Gestosis induced pronounced degenerative processes involving predominantly the liver, kidneys, myocardium, lungs, and ocular retina. This method early detects organ changes in gestosis and thus allows timely specific therapy.

[Premedication with different groups of hypotensive drugs in preparation of patients with concomitant arterial hypertension to planned surgical treatment]. / Premedikatsiia razlichnymi gruppami gipotenzivnykh preparatov pri podgotovke bol'nykh s soputstvuiushchei arterial'noi gipertenziei k planovomu operativnomu lecheniiu.

Investigation of hemodynamic changes in 180 women liable to operations of supravaginal amputation were carried out in order to chose the optimum method of curative premedication in patients with essential arterial hypertension. The results obtained show that Adalat in dosage 60 mg daily during 7 days is most effective in cases with concomitant border-line hypertension. Anaprilin in dosage 160 mg daily and Adalat in dosage 60 mg/day during 7 days have the best hypotensive effect at the first stage of essential hypertension. Clopheline in dosage 300 mg/day or Adalat in dosage 60 mg/day during 7 days are most expedient in the course of hypotensive preparing the patients with the II stage of essential hypertension.

[The prevention of the hemorrhagic and pulmonary complications of extracorporeal detoxification in the multiple organ failure syndrome]. / Profilaktika gemorragicheskikh i legochnykh oslozhnenii ékstrakorporal'noi detoksikatsii pri sindrome poliorgannoi nedostatochnosti.

Based on an analysis of results of treatment of 216 patients with the syndrome of polyorganic insufficiency the authors have developed a method of extracorporal detoxication without using heparin. It includes preoperative haemodilution, administration of antithrombic deaggregating drugs. It leads to less amount of complications in efferent therapy of polyorganic insufficiency.

[Effect of heparin on the pulmonary surfactant system in experimental studies]. / Vliianie geparina na surfaktantnuiu sistemu legkikh v éksperimente.

Experiments were performed in 9 dogs and 20 rats. The effect of heparin (3-4 mg/kg of the body weight) on the lung surfactant was studied under conditions of bacterial endotoxic shock. Heparin was found to decrease the surfactant content in lungs by 57.6% in intact animals, while under conditions of endotoxic shock by 92.2% as compared with the initial level.