[Clinical efficacy of the antimicrobial drug furamag in nosocomial urinary tract infections].

AIM: To evaluate the efficacy of the combined drug furamag (furasidine potassium and magnesium hydroxycarbonate) in combination with the third-generation cephalosporin cefotaxime versus cephalosporin monotherapy for nosocomial urinary tract infections (NUTI). SUBJECTS AND METHODS: The randomized open-label comparative parallel group clinical trial enrolled 52 male and female patients aged over 18 years with a documented diagnosis of NUTI. Group 1 (a study group) took oral furamag 300 mg/day in combination with intravenous cefotaxime 6 g/day; Group 2 (a control group) received cefotaxime monotherapy. The duration of therapy in both groups was 7 to 10 days until the efficiency levels were achieved. RESULTS: A final efficiency analysis was made in 24 and 25 patients from Groups 1 and 2 who had different forms of NUTI (catheter-associated NUTI, cystitis, pyelonephritis). On day 3 of treatment, most patients were noted to have a decreased systemic inflammatory response; lower C-reactive protein and procalcitonin levels being in the study group patients. The clinical efficiency of antibacterial therapy, which had been evaluated both immediately after treatment termination and during further control, did not substantially differ in the furamag/cefotaxime combination and control groups although there was an obvious tendency towards the more marked effect of combined therapy 7-14 days after treatment (11.8% efficiency differences; p>0.05). Analysis of bacteriological efficacy revealed its most pronounced and clinically significant differences between the groups: the cefotaxime/furamag combination led to higher pathogen eradication in all follow-up periods: after 3 days of treatment (82.6%) and following a complete therapy cycle (95.8%) versus the cefotaxime monotherapy group (43.5 and 70.8%, respectively; p<0.01). Microbiological results showed that the major NUTI pathogens (Escherichia coli, enterococci) were more susceptible to potassium furasidine (furamag) versus cefotaxime. The in vitro higher activity of furamag versus cefotaxime was attended by the significantly higher eradication of one of the two important NUTI pathogens - Enterococcus faecalis. CONCLUSION: Furamag used in combination with the third-generation cephalosporin cefotaxime showed a higher bacteriological efficacy and a rapider reduction in the symptoms of a systemic inflammatory response in patients with NUTI. On the basis of the findings, the above combination of furamag and cefotaxime may be recommended as first-line therapy for NUTI when multidrug- resistant nosocomial infection pathogens are widely distributed now.

[Experience of medical backup of military parade on Red Square. Authors showed data about medical backup of military personnel taking part in the parade on Red Square dedicating to anniversary of victory in the Great Patriotic War].

Authors showed data about medical backup of military personnel taking part in the parade on Red Square dedicating to anniversary of Victory in the Great Patriotic War. Experience of running such events allowed to work out an algorithm for medical service: preparatory stage, training stage, running of parade, stage of move out to permanent base. During the parade on Red Square for medical care asked 18 people (participants of parade and civilians). Authors came to conclusion that as a result of medical backup of military personnel taking part in the parade no infectious and group diseases were registered.

[Synergetic basis of the system of specialized medical care, specialized treatment and medical rehabilitation of minimally injured and minimally ill].

The article is devoted to analysis of the current system of specialized medical care, specialized treatment and medical rehabilitation of military casualties of minor nature. The author suggested a synergistic approach to combination of the given system with the aim of determination of development conception. Two main schemes of organization of specialized medical care are considered: medical care during the military conflict and local war; medical care during the regional and large-scale war. Taking into account the function of military field hospital for the treatment of walking wounded it was suggested to add a word combination "center of rehabilitation". The functions of the hospital are considered.

[Experience of medical support organization of the tank biathlon competition].

Authors presented information about medical support of the tank biathlon competition taking part on 12-17 August 2013 at the Alabino. Crews from Belarus, Kazakhstan and Armenia (The Collective Security Treaty Organization) were invited for the contest. On the basis of the idea of the contest and location of the Alabino, the Main military-medical board of the Ministry of Defence of the Russian Federation developed and passed the Programme of medical support of the contest, gave the word to medical service of the Western Military District and central military-medical facilities about appropriation of funds. Personnel, providing the contest, was training every day during the period of preparation. Over a period of field ambulance station 73 people sought medical advice, 12 of them were sent to hospital. Authors came to conclusion the set tasks were completely fulfilled.

[Organization of medical support U.S. Armed Forces].

The article describes the structure of the medical service of the U.S. Army, presented by seven corps,principles of planning of capabilities of medical services and their management, personnel policy of the Medical Service, that focuses on the staffing of the medical service of the officers of the possibilities. Organization of medical care during the combat theater provided by 4 echelons is represented. The first echelon "battlefield-Battalion", the second--"brigade combat team", the third is the rear of the theater of operations, the fourth--stationary hospitals outside the theater of operations. The basic direction of reducing the medical costs of all the troops: military personnel, their families, civilian employees of the Ministry of Defence, members of their families, veterans of military service and their families.

[The experience of 183 medical special forces of the Volga-Urals Military District in the elimination of the health effects of the emergency in the Republic of Indonesia].

The article is based on personal experience of the authors with assistance in the aftermath of the tsunami in the Republic of Indonesia, which killed about 120 thousand (December 26, 2004 at 255 km to the west coast of Sumatra). In the disaster area were sent to 183 medical detachments for special purposes of the Volga-Urals Military District, reinforced brigade of specialized medical care of military medical institutions under the central government and the Moscow Military District. As the authors noted, in the aftermath of a disaster like the tsunami, at first put forward preventive measures among displaced persons. The experience gained by the Medical Service of the Armed Forces of the Russian Federation in the aftermath of natural disaster in the Republic of Indonesia, is used to plan future humanitarian operations abroad with the assistance of military medical specialists from Russia.

[Experience with mobile units of Disaster Medicine Service of the Russian Defense Ministry in local wars and armed conflicts].

The article describes the experience of using of mobile medical units for medical support of combat operations in the armed conflicts in the North Caucasus. The factors affecting the operation of medical services in local wars and armed conflicts are analyzed. Suggestions for the optimization of organizational structure and principles of the use of mobile units service Emergency Medicine are formulated.

[Status and directions of improving of surveillance subsystem of sanitary-epidemiological situation in the service of emergency medicine of the Ministry of Defense].

The article provides a description of the composition and tasks of government, forces and means of preventive direction of Disaster Medicine Service in countering the biological threats. The subsystem of supervision of sanitary-epidemiological situation, functioning at the central, regional and territorial levels is entrusted with the organization and conduct of monitoring activities, monitoring, assessment, prediction, prevention and elimination of the adverse health and sanitary emergencies. The author suggests the promising areas of optimization of the subsystem of supervision of sanitary-epidemiological situation.

[Service for Disaster Medicine of the Ministry of Defence of the Russian Federation at the present stage].

The basic documents of the history of service Disaster Medicine in the USSR and the Armed Forces of the country, employed in this branch of medical terminology, classification of emergency situations are presented. The problem of Disaster Medicine Service of the Ministry of Defence of the Russian Federation at the present stage, the levels of its operations and readiness, as well as the structure and objectives of the medical detachment for special purposes are considered. The involvement of service in peacekeeping operations and medical support of local armed conflicts are assessed.

[Historical aspects of formation of Disaster Medicine Service of the Ministry of Defence of the Russian Federation].

International and domestic experience of recent years is convincing evidence that military medical staff can and should be an important part of the national system of emergency medical assistance in emergency situations. The article is concerned with the participation of military medical personnel in Russia and the USSR in the aftermath of natural and technological disasters in the twentieth and twenty-first century. Historical background and 20 years of experience in the formation of Disaster Medicine Service of the Ministry of Defense of the Russian Federation.

[Disturbances of blood lipid content after acute disorders of brain blood flow].

The parameters of blood lipid spectrum have been analyzed in 421 patients who survived cerebral stroke and transitory ischemic attacks in 2004-2008. The study included people of Khanty-Mansiysk and Khanty-Mansi autonomous okrug and watchmen. The statistical analysis did not reveal differences between mean concentrations of total cholesterol, high and low density lipoproteins and triglycerides in the settled population and in watchmen. Mean values of all parameters, with the exception of high-density lipoprotein, were higher compared to normative values. The highest frequency of deviations was found for low-density lipoproteins (63.5% of cases). The highest concentrations of total cholesterol and low-density proteins were seen in patients after transitory ischemic attacks regardless of their sex. The comparison of blood lipid spectrum parameters in different age groups revealed significant differences only for total cholesterol.

[Application of new technologies in the design, manufacture and use of technology deployment of field medical units and establishments].

Presented data is about attendance means of deployment of field medical units and pieces of army-level medical services and disaster medicine Defense Ministry did not ensure compliance with requirements to create optimal conditions for highly effective work of the medical staff, placing the wounded, the use of modern aids and appliances. The prospects of creation of mobile unit for high-availability modular pre-fabricated on the basis of tent structures, pneumoconstructions and removable habitable bodies, containers, tents, pneumocovers till 2020 are analyzed. Livelihood systems provide armor protection against fragments, bullets, flames, damaging factors of chemical and biological weapons.

[Analysis of the use of field medical units in the armies of NATO and Russian Armed Forces].

An analysis of medical services of NATO and the Medical Service of the Armed Forces of the Russian Federation of modern technology deployment stages of medical evacuation (tents, inflatable structures, shelters, containers, medical armored vehicles, cars, etc.) is presented. Examples of their usage in isolated employment, usage in the group as a mobile medical stations and field hospitals in various conditions, the prospects and directions of development of technical means deployment of medical service are given.

[Organization of medical equipment and stock supply of military medical facilities and groups of Disaster Medicine Service of the Russian Defense Ministry in emergency situations].

The article outlined the modern concept of medical equipment and stock supply of medical facilities and groups of Disaster Medicine Service of the Russian Defense Ministry involved into the remedial of the medical actions of emergency situations. The structure of the units of medical supplies in these conditions is presented.

[Organization of medical support of troops in the course of Georgia peace enforcement operation].

In the course of operation the medical armed units and institutes of permanent readiness realized the buildup of forces and measures of the medical service. Supplementary were provided: to enforce the 236th military hospital (Vladikavkaz)--group of medical enforcement from Main and central military hospitals; to enforce the 1602nd regional hospital (Rostov-on-Don)--brigade of specialized medical aid of MMA of Kirov S.M.; the 183rd separated medical group of special purpose (semegosp SP) (PUMR). From 14 to 28 of August 2008 the 529 semegosp SP provided the medical aid to 456 patients (350 persons of them were servicemen), 221 persons were hospitalized, 136 persons were evacuated. Additionally an autobandaging room was established in the structure of surgical group. From 14 to 28 of August 2008 the 183 MU SP provided the medical aid to 115 patients (104 persons of them were servicemen), 32 persons get a stationary treatment, 21 persons were hospitalized, 25 persons were evacuated, 8 persons were discharged. Generally, medical service, which took party in operation of Georgia peace enforcement, realized all missions.

[Infective endocarditis of staphylococcal etiology: clinical process and antibacterial therapy].

Characteristics of the clinical process of staphylococcal endocarditis in 115 inpatients and the adequacy of various regimens for their antibiotic therapy within a period of 10 years were analysed. Four clinical criteria for prognosis of staphylococcal endocarditis were determined: intravenous narcomania, splenomegalia, leukocytosis and hemorrhagic skin eruption. The analysis of the Russian and foreign findings showed that the use of betalactams (oxacillin, the 1st and 3rd generation cephalosporins) and lincomycin provided the adequate therapy resulting in eradication of the pathogen in case of oxacillin resistant staphylococci, whereas the use of ciprofloxacin and vancomycin was inexpedient. In case of MRSA it was recommended to use vancomycin and in case of endocarditis due to S. aureus with intermediate resistance to vancomycin (VISA, MIC > 0.5 mcg/ml) the use of linezolid was recommended.