Том 334, № 2 (2013)

The round-up

Results of treatment and inspection of 278 patients with purulonecrotic complications of diabetic foot, treated in septic surgery department of 3rd Central Military-Clinical Hospital n. a. A.A.Vishnevsky during 1999—2009 are analyzed. For patients with purulonecrotic forms of diabetic foot is necessary to perform complex therapy with participation of endocrinologist and angiosurgeon, in specialized departments with the necessary medical equipment and dressing means and having experience of treatment of patients with diabetic foot, characterized with heavy and long-lasting course of disease leading to amputations. At the same time, application of gelling dressing means, iodoforms with ferment drapes for local treatment allowed to lower a level of amputations from 17,1 to12,8%, and also to reduce stay of patients in a hospital to 8 days.

The author researched risk factors for atrial fibrillation in 93 patients with atrial flutter after radiofrequency ablation of cavotricuspid isthmus. Effectiveness of radiofrequency ablation of the inferior isthmus was 93,5%. Before operation in 10% patients from the group of patients without atrial fibrillation, in postoperative period developed atrial fibrillation. Factors for this arrhythmia include elderly age, low contractility of the aortic ventricle of heart, dilation of the left atrium, chronicity and rate of arterial hypertension. In group of patients with atrial fibrillation in pre-and postoperative period this arrhythmia developed in 73,9% of patients. Risk factors for atrial fibrillation include elderly age, time duration of arrhythmic anamnesis and chronicity and rate of arterial hypertension.

The aim of the study was to determine the correlation between the state of the individual functions of the organism and the intensity of decompression venous gas embolism after high air pressure exposure. The analysis of the guidelines defining the procedure of divers’ medical examination was made and 320 divers were surveyed. Indices of the divers’ central nervous and cardiovascular systems were measured before and after their immersion into a hyperbaric chamber. The study found that the conduct divers’ on-resistance to unfavorable scuba dive should be provided by the military-medical commission, so the position of diving doctor should be put to it staff It was revealed that the rate of simple visual-motor reaction, measured before the diving can serve as an indicator of human resistance to decompression gassing. The formula for determining the stability of decompression gassing of men aged 20—30 years in terms of state of organism functions was proposed.

The US Air Force and Coast Guard. The present article is the last part of the review dedicated to organization and management of medical research in the US Armed Forces. The first through fourth parts were published in the previous issues of the journal. Specifically this article is dedicated to organization and management of medical research in the US Air Force and Coast Guard. It is shown that in the US Air Force the medical research is conducted in the Air Force Research Laboratory and in the US Coast Guard — in its Research and Development Center. The particular research programs conducted in the above mentioned units are discussed.

Clinical care of national navy hospitals was normed from reception of patients till hospital discharge. After admission to the hospital, patient got competent medical care and corresponding attendance. But the situation changed in XVIII century, period of wars. In conditions of war time hospitals were overcrowded with patients and wounded. The number of patients went beyond the bedspace. Deficit of vacant beds was supplied with the help of additional beds; deficit of medical staff was supplied with the help of participation of another medial staff. Huge number of patients with different diseases, including contagious diseases, conduced communication of contagious diseases inside the hospital. Diagnostics and methods of treatment of these diseases were not enough researched. Taking into account results of statistical analysis of data about the number of fatality cases (peace time — 4—10%, war time — 20%), we can make a conclusion that clinical care of national navy hospitals was satisfying.