[Clinical and experimental study of the peculiarities of cardiac activity disorders during poisoning by combustion products in persons of different age groups.]

The work is carried out to clarify the mechanisms of cardiac activity disorders and assess the severity of cardiotoxicity in acute poisoning by combustion products in the age aspect. 71 patients with severe carbon monoxide poisoning were examined. The comparison group consisted of 22 patients with acute severe opiate poisoning. The methodological basis of the clinical study was daily monitoring of ECG. The studies were performed in 1 and 3-4 days. Residual cardiac dysfunction was estimated at 12-14 days. The comparison group selected 14 patients with acute myocardial infarction at this stage. Pathomorphological changes were studied on the cadaveric material of 24 experimental animals exposed to carbon monoxide at a dose of 16 g/m3 for 5 minutes on 31 days from toxic injury. It is established that acute poisoning by combustion products leads to the development of severe electrophysiological disorders classifying cardiotoxic effect as severe or extremely severe. Expression of signs of cardiotoxicity is higher in middle-aged and elderly patients. In the outcome of the poisoning, all the victims have formed a toxic cardiomyopathy.

[Directions of interdepartmental interaction in case of delivery of health care for injured in emergency situations in stationing sites of navy].

In points basing of navy will remain probability of emergence of emergency situations which is connected with existence of the enterprises of the industry and objects of navy. As a result of emergency situations in places of basing of navy discrepancy of prospective sanitary losses to possibilities of forces and means of a health service of fleet that demands interaction with health services of other ministries and departments is probable. Criterion of need of interaction is the ratio of quantity struck and possibilities of a health service of navy. Plans of interaction of a health service of fleet with medical institutions of other departments should provide options of use of available forces and means of medical institutions in garrisons for joint assistance struck in an emergency situation. The questions solved during interaction should become: radiation, chemical, biological survey; allocation of forces and means for rendering of medical care; use of sanitary transport; organization of sanitary processing, etc.

[Expert assessment of commands of naval medical service, incorporated in Service for Disaster Medicine].

Expert assessment of possibilities of naval medical service for delivery of assistance in emergency situations in deployment areas is performed. It is noted that the main menaces are radiation, chemical accidents, and explosiveness of objects. Inconsistency between supposed losses and possibilities of naval medical service is probable in case of emergency. This inconsistency requires improvement of interaction with medical services of other ministries, drill of coordinative actions of naval medical commands with other commands of other ministries in organizational frames of united Service for Disaster Medicine.

[Correction of mnestico-intellectual disturbances in the somatogenic phase of acute poisoning with a mixture of psychotropic drugs].

A total of 60 patients suffering acute poisoning with a mixture of psychotropic drugs were available for observation. The study focused on comparative estimation of reintegration of psychic conditions (recovery of consciousness, conceptualization of mnestico-intellectual functions) in these patients. It was shown that intensive therapy of toxic and hypoxic brain lesions with antihypoxic agent cytoflavin results in rapid and effective reintegration of psychic activity including recovery of consciousness and conceptualization of mnestico-intellectual functions.

[Using of reamberin on patients with cerebral deficiency due to severe forms of acute poisonings].

The aim of work was to test the using of reamberin on patients with cerebral deficiency due to severe forms of acute poisonings. The investigation was made on 60 patients (38 men and 22 women), whose average age was 34.7 +/- 2.6 (for men) and 28.4 +/- 3.2 (for women). The main group was divided into two parts, which had compared age, sex and gravity of condition. The first one was given reamberin with standart therapy (I - 32 patients), the second - only standart therapy (II - 28 patients). It was revealed that using of reamberin in complex therapy of acute cerebral deficiency lead to decrease of intensity of cerebral deficiency and to increase of speed of cerebral activity rehabilitation. These changes lead to improvement of clinic tendency of cerebral deficiency, what was illustrated by decrease of comatose period from 55.0+/- 2.2 to 33.0 +/- 2.6 hours, decrease of the time of being in reanimatology department from 69.1+/- 3.6 to 53.4+/- 4.3 hours.

[The use of cytoflavin in combined neurometabolic therapy of acute cerebral insufficiency associated with acute poisoning with neurotropic poisons].

Examination and treatment of 262 patients with severe acute intoxication by neurotropic poisons and unaffected oxygen delivery system showed that inclusion of cytoflavin in combined neurometabolic therapy of acute cerebral insufficiency significantly reduced severity of metabolic disorders. Specifically, tissue hypoxy, endotoxicosis, lipid peroxidation activity, and immunosuppression decreased while antioxidative protection and clinical picture were improved. Duration of comatose state and artificial lung ventilation was reduced from 64.5 +/- 15.1 to 28.8 +/- 10.2 hours and that of critical condition from 117.2 +/- 17.2 to 63.7 +/- 9.2 hours. Overall lethality dropped from 16 to 9.9%.

[Method of express evaluation of physiological resources in individuals with intensive and long occupational activities].

The authors specified and tested an index of occupational functional resources in specialists with intensive and long occupational activities.

[Cerebral hypoxic lesions in the early phase of acute intoxications with neurotropic poisons: development, course, and ways of correction].

The paper presents the results of examination and treatment of 147 patients in the early phase of severe acute intoxications with neurotropic poisons. The use of the methods of assessing the bioelectrical activity of the brain has been found to objectively evaluate the degree of CNS suppression, to clarify the nature of the damaging action of a toxic agent, and to evaluate the efficiency of therapy. The use of cytoflavin in intensive care for cerebral hypoxic lesions has been shown to substantially decrease the degree of brain lesions.

[Blood cell aggregation and oxidative stress in pathogenesis of ischemic stroke]. / Agregatsiia kletok krovi i okislitel'nyi stress v patogeneze ishemicheskogo insul'ta.

Rheologic properties of blood cells and a state of oxidative-reductive processes and blood systems have been studied in 75 patients in acute period of ischemic stroke. The signs of oxidative stress development and simultaneous augmentation of blood cells aggregation were found. Shifts of redox-equilibrium in thiol-disulfide and ascorbate oxidative-reductive blood systems and cells aggregation dependence on their state were detected. An interrelation of oxidative processes and blood cells aggregation with clinical course severity and outcome was revealed. The authors discuss possible mechanisms for blood cells aggregation in oxidative stress. Including of antioxidants in the pathogenetic therapy and their earlier usage reduce essentially the intensity of oxidative stress and blood cells aggregation and promote neurological symptoms regress. The results obtained allow considering antioxidant treatment as a pathogenic modality for prevention and treatment of ischemic stroke. Clinico-laboratory correlations suggest a pathogenic role of oxidative stress in ischemic stroke as a factor augmenting aggregation processes and promoting intravascular thrombogenesis.

[Effect of secondary prophylaxis on quality of life in gerontologic patients at the rehabilitation center for the disabled Patriotic war veterans in local sanatorium]. / Vliianie vtorichnoi profilaktiki na kachestvo zhizni gerontologicheskikh bol'nykh v usloviiakh tsentra reabilitatsii invalidov Otechestvennoi voiny na baze mestnogo sanatoriia.

AIM: To study efficacy of sanatorium treatment of aged patients with gastroenterological and locomotor diseases in the heriatric center. MATERIAL AND METHODS: 100 patients were investigated for effects of sanatorium treatment on quality of life. RESULTS: Clinical symptoms depended on the patients' age. Patients under 70 years of age had leading symptoms from gastrointestinal organs and locomotor system. These patients were most responsive to rehabilitation measures. In 70-year-olds and older patients cardiovascular and cerebral pathologies are of special importance limiting usage of physiotherapy and necessitating wider application of medicines: hypotensive, antianginal, circulation correcting, etc. The sanatorium stage of rehabilitation creates a positive emotional background in these patients. CONCLUSION: Sanatorium treatment resulted in improvement of life quality in gerontological patients.

[Psychophysiological condition of wounded]. / O psikhofiziologicheskom sostoianii ranenykh.

Psychological and psychophysiological investigation of the casualties with injured extremities was conducted in 3-5 and in 30-40 days after being wounded. It has shown that during stay in clinic some dynamics in their psychic state was observed. Marked asthenization was the leading sign in the initial treatment period. That's why it is reasonable to use not exhausting projective methods and some short questionnaires (scales) at this stage. In a month after starting treating the casualties the aggressive tendency, mood decrease, increase in the reactive anxiety level, sympathetic tonus of vegetative nervous system were coming into the foreground. It characterizes the development of posttraumatic stress disorders. Gradual increase in the casualties' activity is also typical of the hospital treatment period. That's why the psychological and psychophysiological investigation can be supplemented with volumetric personal tests.

[Mechanisms of adaptation effect of normobaric hypoxic therapy]. / Mekhanizmy adaptatsionnogo éffekta normobaricheskoi gipoksiterapii.

It was discovered that brain adaptation to long-term hypoxia operates primarily through lowering frequency of dominating spontaneous activity. EEG parameters can help in assessment of acute hypoxia and predict effectiveness of hypoxic therapy. Patients with definite response to rhythmic photostimulation in the range of alpha-activity tolerate hypoxia well. High presentation of slow waves in the pattern of the initial EEG, especially of teta-rhythm predicts formation of adaptive effect in hypoxic therapy.