[Results of surgical remodeling after resection of aneurysm and plasty by Dor-II-Jatene method in patients with post-infarction aneurysms of the left ventricle].

Post-infarction remodeling was studied in 41 patients with the post-infarction aneurysm of the left ventricle and initially reduced contractive function of the left ventricle myocardium: ejection fraction from 17 to 35%. The ultrasonic pre- and postoperative investigation allowed assessment of the index of the ultimate diastolic volume, index of the ultimate systolic volume, ejection fraction, long axis of the left ventricle, apical short axis, papillary short axis, mitral short axis. In addition, impaired obliquity of the left ventricle cavity and relative thickness of the left ventricle wall and intervenricular septum at different levels were determined. Surgical remodeling using resection of aneurysm and plasty by Dor-II-Jatene method facilitated normalization of indices of the cavity geometry and reestablishment of the contractive ability of the left ventricle.

[Estimation of health damage caused by burns].

In the article were considered peculiarities of the estimation of damage weight to the health in conditions of ambustion affects. Also in the article was shown the actuality and practicability of elaboration of qualifying features of ambustion affects for purposes of medicolegal investigation.

[Specialized surgical aid for combined burn trauma in armed conflicts in Northern Caucasus].

The article presents the experience of delivery of specialized health care to injured persons with combined ambustions during battle actions on the territory of Chechenian Republic (1994-1996, 1999-2002). It was effectuated the analyze of delivery of health care in 202 cases of combined ambustions, wherein the ambusions is predominates: 87 in 1994-1996 and 115 in 1999-2002. In the structure of sanitarium losses the burned took 4.1% and 6.4%, in accordance. During different periods of battle actions combined ambustions took from 11 to 24% of all burns. Active surgical tactics of treatment of injured with combined ambustions, based on using of small-invasive methods of diagnostics and treatment, permits to degrade general lethality from 13.5 to 7.3%, and lethality between injured with middle and hard degree of gravity on 19 and 14% (p < 0.05). It's showed that it is wise to use a group of specialized medical aid on single direction for delivery of health care to injured with combined ambustions.

[Medico-diagnostic strategy in patients with postinfarction aneurysms of the left ventricle in combination with aneurysms of the abdominal part of the aorta].

The authors describe the algorithm of examination and methods of operation on 24 patients. It allowed shortening the time of compression of the aorta, of acute ischemia of the lower extremities, less operation blood loss, exclusion of postoperative lethality.

[Surgical treatment of patients with post-infarction aneurysm of the left ventricle and diffuse lesion of the anterior interventricular artery].

Diffuse lesions of the anterior interventricular artery (AIVA) at different levels were diagnosed in 27 out of 417 patients operated for post-infarction aneurysm of the left ventricle (PIALV). During the preoperative period coronography, ventriculography, ultrasonic examination of the heart were made in all the patients, one-photon emission computed tomography with 123I-iodopent was used for radioisotope investigation of perfusion and metabolism of the myocardium. The presence of PIALV, diffuse atherosclerotic lesion of AIVA and viable myocardium in its basin was taken as an indication for autovenous plasty of the artery with the following shunt of the left intrathoracic artery and resection of PIALV.

[Frostbites amongst service men, participants of contreterroristic operations on North Caucasus (1994-1996, 1999-2001)].

In clause the analysis of the rendering medical help military is reflected in article with frostbites in military conflict on North Caucasus (1994-1996, 1999-2001). Efficient rendering medical help military with frostbites possible only under simultaneous observance united principle on terminological glances and provision to receivership approach to organizations of the rendering medical help damaged military. It is generalised and analysed own experience of the rendering medical help military with frostbites during military conflict on territory of the Chechen Republic (2003-2005).

[Surgical treatment of patients with postinfarction aneurysm of the left ventricle in combination with atherosclerotic lesion of the lower extremity arteries].

Examinations and operations on 36 ischemic heart disease patients with postinfarction aneurysm of the left ventricle (PIALV) in combination with hemodynamically significant obliterating atherosclerosis of the lower extremity arteries were performed in the clinic during the period from 1995 through 2005. The first stage of the treatment included resection of PIALV and myocardium revascularization. Positive results were obtained in all 36 patients at the first stage of surgical treatment, without ischemia of the myocardium being observed in the postoperative period. The contractive function of the left ventricle as an ejection fraction due to resection of PIALV and its plasty was on average 17% greater, which created favorable conditions for the following stage of surgical treatment. At the second stage of surgery an individual approach was used for patients with generalized atherosclerotic lesions of the lower extremities with special reference to specific clinical picture, as well as non-standard surgical methods. Among the nonstandard surgical methods there were transprosthetic aortotomic shunts and the method of a reverse formation of anastomoses.

[Surgical treatment of patients with a postinfarction aneurysm of the left ventricle and postinfarction incompetence of the mitral valve].

The authors have analyzed results of treatment of 18 patients with postinfarction aneurysms of the left ventricle (PALV) and postinfarction insufficiency of the mitral valve (PIMV) operated upon after examination. It is considered that both the mitral valve (MV) replacement and some kind of plasty, which is more preferable, can be used in patients with PALV and PIVM in order to recover the closing function of MV. Dosed resection of PALV and its plasty by the Dor-II Jatene method allowed the LV cavity geometry to be reestablished and thus the MV fibrous ring sizes to be reduced as well as the degree of the valve insufficiency. It is expedient to use the method of cardioplagia in such patients and to fulfill proximal anastomoses with the aorta at the lateral pulled position on the working heart and then to start extracorporeal circulation.

[Ways of optimization of air-medical evacuation of wounded and ill patients during the armed conflict].

The article is devoted to the experience of airmedical evacuation struck during operations in territory of the Chechen Republic of 1999-2002. We consider, that optimal medical-evacuation system in local wars, local fight actions and battles consists only two stages, then victim after first physician aid is evacuated to specialized medical unit. Own experience of preflight preparation and support is generalized and analysed at carrying out of airmedical evacuation of 928 critically wounded patients and the struck on tactical, operative and strategic levels during a confrontation in territory of the Chechen Republic (1999-2002).

[The modern approaches to the choice of infusion agents used in the treatment of severe injuries and burns].

The article presents an analytical review of modern possibilities of the complex pathogenic treatment for severe traumas and injuries at the expense of systemic use of infusion drugs with antihypoxic and antioxidant effects. It is shown that hypoxia and oxidative stress is the typical; pathologic process that accompanies the development of traumatic disease during severe surgical pathology. One of the effective ways to correct the developing disorders is to use the regulatory or substrate antihypoxants as well as the drugs with antioxidant effect.

[Combined and multifactorial burn injuries in military conflicts: tactical approaches to diagnosis and treatment].

The article reflects the experience of the treatment of the servicemen with combined burn injuries got in the Chechen Republic (1994-1996, 1999-2001). 266 causes of medical treatment for combined injuries where the burn was decisive were analyzed: 141 of which were got in the Chechen Republic in 1994-1996, 10 - in Daghestan in August-September of 199 and 125 - in the Chechen Republic in 1999-2001. In the structure of sanitary losses with surgical profile the burnt amounted to 4,1%, and 6,4%. The development of the medical treatment system made it possible to reduce lethality from 13,5% to 7,5% (P < 0,05). The optimal option of the medical evacuation organization in local military conflicts and wars is a two-stage scheme of evacuation, the first stage is premedical care ann the second is qualified (specialized) medical care.

[Towards the problem of necessity to reduce the medical evacuation stages in conditions of local wars and armed conflicts]. / K voprosu o neobkhodimosti sokrashcheniia étapov meditsinskoi évakuatsii v usloviiakh lokal'nykh voin i vooruzhennykh konfliktov.

The article is devoted to the review of modern opinions concerning the experience of military operation medical support in conditions of local wars and military conflicts. On the base of analysis of medical assistance rendered to the wounded and casualties in Republic of Chechnya the advantages and defects of different approaches are discussed. The experience in rendering assistance to the casualties in the Armed Forces of NATO countries during the local wars for the last decades is discussed. It is shown that the optimal variant of organization of treatment-and-evacuation measures during the local armed conflicts and wars is the two-stage scheme of evacuation: the first medical aid--the qualified (specialized) medical aid.

[Modern principles of the pathogenetic therapy of the burn shock]. / Sovremennye printsipy patogeneticheskoi terapii ozhogovogo shoka.

The article is devoted to the review of main directions of anti-shock therapy improvement for patients with severe burns. It is shown that the treatment efficiency can be considerably increased both by optimization of infusion volume and by the use of modern infusion drugs with anti-hypoxic and anti-oxidant effects. The use of anti-hypoxic and anti-oxidant drugs permits to change the burn shock course and to decrease its duration. Decrease in severity of tissue hypoxia, prevention of cellular membrane injury interrupt one of the circuits of burn disease pathogenesis and create the favorable conditions for realization of acute adaptation mechanisms in terms of traumatic disease conception. The modern schemes of anti-shock therapy approved at the department of thermal injuries were used in the treatment of casualties with combined burns after the armed conflict in the territory of Chechnia (1999-2001).

[Medical care for the burnt in modern local military conflicts]. / O meditsinskoi pomoshchi obozhzhennym v sovremennykh lokal'nykh voennykh konfliktakh.

The article is devoted to the experience of treatment of the servicemen who burned during the hostilities in Afghanistan (1979-1989), Tadjikistan (1992-1994) and in Republic of Chechnya (1994-2996). Medical care rendered in 18,921 cases of burns and combined trauma (the burn prevailed) is analyzed: 1201--in Afghanistan, 205--in Tadjikistan and 415--in Republic of Chechnya. In the structure of sanitary losses of surgical character the burned persons constituted 2.5% in Afghanistan, 7.0%--in Tadjikistan and 3.9%--in Republic of Chechnya. The most effective was the medical-evacuation system in Afghanistan. The optimal medical-evacuation system during the local armed conflicts and wars is the evacuation consisted of two stages: first medical aid--specialized medical care.

Effect of Erysod (erythrocyte superoxide dismutase) on blood concentration of reactive oxygen species in patients with severe burns and burn shock.

The dynamics of blood concentrations of reactive oxygen species and LPO products in patients with thermal injuries of different severity was studied. Monitoring of these parameters by chemiluminescent and spectrophotometric techniques helps to predict the course of burn shock and prevent complications. Erysod (0.004% solution, 33-66 microg/min, daily dose 24-32 mg) added to antishock infusion therapy during the early periods after injury suppressed generation of free radicals (by 20% after 15 min and by 30-40% after 24 h), promoted normalization of their contents, and reduced damage to visceral organs during acute period of thermal injury.