Vol 338, No 11 (2017)

A clinical audit of 50 hematological patients in the departments of hematology (37) and bone marrow transplantation (13) was carried out. The problems that require an audit have been identified and a strategy for their solution has been worked out. The characteristics of the stages of clinical audit are presented. The implementation of requirements for the use of antimicrobials in patients with neutropenia, the implementation of a set of measures for the diagnosis of neutropenia, as well as compliance with recommendations for the care of patients are assessed. The full implementation of the latter in the department of bone marrow transplantation and partial (25-85%) - in the department of hematology was established. An assessment was made of the extent to which the standards of antibiotic therapy and patient care for each department were complied with. A high level of bacteremia in patients with neutropenic fever was revealed. Questionnaires on the clinical audit of antibacterial therapy and compliance with the rules of care for patients with neutropenic fever, which will improve the quality of medical care.

The radioprotective efficiency of b-estradiol was studied in its preventive administration under conditions of acute irradiation of mice. We studied 30-day survival, the average life expectancy of dead animals. To study bone marrow hematopoies, methods of endogenous and exogenous colony formation were used, and the dynamics of hematological parameters of irradiated mice were determined. It has been established that the prophylactic use of b-estradiol at a dose of 20 mg/kg for 5 days prior to radiation exposure protects against radiation death of animals exposed to radiation at doses of SD50-70/30, increasing their survival by 17-58%, and contributes to a decrease in the severity of post-radial disorders of bone marrow hematopoiesis.

The influence of high thoracic epidural block with Naropin® on the diastolic function of the left ventricle in patients with unstable angina has been studied. The study was performed on the basis of analysis of the results of examination and treatment of 36 patients, men aged 66,3±2,1 years, suffering from coronary heart disease with unstable angina and disturbing diastolic function of the left ventricle. In 24 patients, the left ventricular ejection fraction was lower than 50%. A local anesthetic Naropin® (0,5% solution) was administered epidural at a dose of 50-150 mg per day for 1-7 days before stabilization. The study (Doppler echocardiography) was performed an hour after the epidural blockade. It is proved that epidural blockade improves local and global contractility of the left ventricle, its diastolic function, increases perfusion in the area of stenotic coronary vessels. The revealed properties of epidural blockade allow us to recommend it as an effective means of intensive care for unstable angina.

The article presents an assessment of the etiological structure of respiratory infections, based on data on sicknesses of conscripts during the epidemic of influenza and acute respiratory viral infections in 2016-2017. The high epidemiological significance of the viruses of non-influenza etiology was determined, which was determined 3,3-4,5 times more often among the patients in different collectives than the influenza viruses. The share of adenoviruses detected in patients with acute respiratory viral infections was 53,3-75% of the total number of identified viruses, which indicates the need for additional protection of the military personnel with antiviral drugs.

Current expert tasks in examining victims and people acting as a possible source of sexually transmitted diseases and HIV infection should be clearly structured and solved in a certain sequence, dictated by the content of clinical and laboratory examinations and analyzes. The evaluation of the data obtained should be carried out in accordance with the content of articles 121 and 122 of the articles of the Criminal Code of the Russian Federation and the results obtained. The main issue of this type of examination is the establishment of medical signs of a causal relationship between the victim’s contact with the suspect and the consequences of infection with a particular form of the disease.

A clinical observation of a successful complex treatment of a gunshot craniocerebral injury is described. The presented observation demonstrates the justification of carrying out one-stage reconstructive surgical treatment with simultaneous performing of neurosurgical and maxillofacial stages with restoration of damaged anatomical structures. Psychological rehabilitation plays an important role in restoring the working capacity of such wounded.

The article defines the purpose and ergonomic requirements for a new mean of restoring the functional state of the crew members of a multi-seat aircraft during the flight - day rooms. They are designed for passive rest, hardware, passive and active restoration of the functional state (rehabilitation and prevention), food intake, stay of the shift crew (if available). The basic principles of functioning of day rooms in the rehabilitation and preventive mode, requirements to the complex recommended for use in the recreation room on board the military aircraft are described.

The results of testing the set of reagents «DS-DIF-ENTERO-12» for biochemical differentiation of enterobacteria are presented. It is established that the kit has high performance characteristics, its test systems are characterized by reliable specific activity. The high accuracy of identification of enterobacteria to the species with a relatively small number of tests makes it possible to successfully use this kit in the field and in small laboratories.

The Military-medical museum was established on November 12, 1942. It is the successor of the first medical museums: the artisian’s house, the Surgical museum at the Medical-surgical academy, the Museum of the N.I.Pirogov’s surgical society, the Military-sanitary museum of the Red Army and Navy, and others. More than 450 thousand museum items, including more than 300 personal funds of prominent domestic scientists: Botkin S.P., Pirogov N.I., Pavlov I.P., and etc. An archive of military medical documents has been created. The museum conducts scientific research on the history of military medicine, fulfills an important humanitarian mission. The modern stage of the museum’s life is connected with the formation of a new image of the museum, its exposition-exhibition, stock, restoration and other spaces, the material and technical base, as well as the emergence of young creative personnel, the mastering and introduction of new museum technologies. A significant place in the work is devoted to patriotic education, the formation of a fully developed personality. The museum uses a variety of forms of work with visitors (author’s tours, lectures, quizzes, quizzes, quests, etc.). The museum is a permanent participant and a diploma of intermuseum actions and competitions (Night of Museums, Intermuseum, Children’s Days in St. Petersburg, Museum Olympus, etc.).