Том 334, № 3 (2013)

We have performed a post-hoc analysis of the results of using antibacterial therapy in patients with pleural empyema. The cost-effectiveness analysis of rational and empiric antibacterial therapies was performed. The cost-effectiveness ratio for rational antibacterial therapy was lower than for empiric one (2889 and 4480 rubles for 1 treated patient correspondingly). The use of the rules of rational antibacterial therapy in practice leads to proved saving of economic costs

The rationale for cost-effectiveness of modern muscle relaxants (MR) administration in general anesthesia was evaluated. New MRs are more expensive than traditionally used pipecuronium and succinylcholine. However, the old MRs are often required as a block reversion with anticholinesterase medicines at the end of surgery, the longer artificial lung ventilation and observation in patients during recovery in intensive care unit. It was found that the district military hospital had done an annual average of about 900 general anesthesia assisted with artificial ventilation and muscle relaxation. About 2% of all anesthesias accrue to short-term anesthesia, the 27% to medium-term and 71% to long-term. 81% of the medium-term anesthesia accrue small hospitals. According to cost/effectiveness the most optimal muscle relaxants administration scheme for short-term (up to 30 min) anesthesia was mivacurium, for the operation of medium duration (30—120 min) — rocuronium, for long-term (120 min) — pipecuronium. An electronic form of annual report, which allows to obtain the necessary data for calculation of annual muscle relaxants demand and costs both in hospital and in the whole of the armed forces quickly, was developed.

In 2009 pandemic caused by high-path fluenza A(H1N1), so called «swine» flu was registered in the world. Aphylaxis to this type of influenza lead to pandemic. The authors gave an example of fatal course of influenza A(H1N1)S-OIV in young patient with severe VA-pneumonia, acute respiratory distress syndrome, disseminated intravascular coagulation with progressive respiratory distress secondary to an metabolic syndrome. It led to patient’s death. Patient was refractory to all modern methods of intensive therapy in conditions of multifield specialized medical and preventive treatment facility.

The main issues of organization of scientific and research work of medical service in the North Fleet are considered in the present article. Analysis of some paragraphs of documents, regulating this work at army level is given. The authors give an example of successful experience of such work in the North Fleet, table some suggestions which allow to improve the administration of scientific and research work in the navy and also on the district scale.

The US and British models. The present review is dedicated to organization and management of military veteran’s health care system of the US and UK. It is shown that despite the differences in health care systems of both countries their veterans receive the stat-of-the-art medical service which is readily available and financially affordable.

The article is devoted to 70th anniversary of the head state forensic expert institution of the Ministry of Defence of the Russian Federation — 111th Main state center of medicolegal and criminalistic examination of the Ministry of Defence of the Russian Federation. Some information about historical aspects of functioning of the institution and its activity at the present stage and in conditions of the reform of the Armed Forces of the Russian Federation is given.