I Russian Congress with foreign participants “Emergency endoscopy”.

Moscow city scientific-practical conference “Diagnostic and treatment strategy in combined trauma of the chest abdomen”.

Scientific-practical conference, dedicated to the memory of the women-scientists of the Sklifosovsky Research Institute for Emergency Medicine.

Endovascular methods of diagnostics and treatment of cardiovascular diseases.

BACKGROUND. Severe burns are accompanied by the development of endogenous intoxication syndrome. Endogenous intoxication syndrome (EIS) is thus specified as a complex of severe clinical aspects with detoxification systems failure — in other words, the syndrome of multi-organ failure (MOFS) or inefficiency, depending on severity of EIS (compensation, subcompensation, decompensation) [1, 2].

PURPOSE. To improve the results of EIS and MOFS treatment in the patients with severe burns by including into medication succinic acid-based anti-oxidants combined with hepatoprotectors of the ademetionine group.

MATERIAL AND METHODS. We carried out analysis of complex examination and treatment of 108 patients aged 18–50 with severe thermal injury, total burn area (S) ≥40%, and severity index ≥90.

RESULTS. The use of succinic acid-based anti-oxidants within the framework of antishock and disintoxication therapy, later combined with hepatoprotectors of the ademetionine group, decreases the intensity of endogenous intoxication and multi-organ failure syndrome.

CONCLUSION. To treat endotoxemia and multiple organ dysfunction caused by oxidative stress and hypoxia in patients with severe and extremely severe burns, it is appropriate to prescribe succinic acid-based anti-oxidants. To prevent albumen synthesis and detoxication hepar dysfunctions, decrease the manifestations of endotoxemia, and complement the cytoprotective action of succinic acid-based antioxidants, it is appropriate to prescribe hepatoprotectors. 

Abstract. In the format of the information and analytical review of the literature provides the data on injuries among pregnant women. The influence of different mechanism, the degree of the severity and nature of injuries on maternal and perinatal outcomes were shown in the article. The revealed-mined some contradictions had been detected in the results of studies on trauma outcomes depending on the severity and nature, as well as the lack of information on standards of conduct and protocols. 

INTRODUCTION. The development of prognostic criteria in brain trauma associated with extracranial injuries is necessary for treatment results definition, getting of priority rating, establishment time and volume of care, for active management of clinical process and timely complications warning.

PURPOSE. To determine outcomes and predictive value of risk factors in patients with brain trauma associated with extracranial injuries in-hospital stage of medical care.

MATERIAL AND METHODS. Retrospective analysis was performed in 1634 patients who were underwent surgery due to severe traumatic brain injury (TBI). There were 22,1% patients with brain trauma associated with extracranial injuries. Using statistical analysis we determined relationships between outcomes and clinical and instrumental signs, obtained during the examination of patients.

RESULTS. The extracranial risk factors in patients with brain trauma associated with extracranial injuries were: ISS 40 and over, multiple extracranial injuries, spinal or abdominal injury, age 70 and over, arterial hypoxemia and hypotension, complications in postoperative period. The intracranial risk factors were: GCS score 12 and less, oculomotor nerve dysfunction, abnormal pupil reactivity, pathological motor responses or diffuse muscular tone reducing, brain herniation at the stage of midbrain or pons clinically, brain lesions volume over 90 cm3 , lateral dislocation over 10 mm, absence of basal cisterns on CT scan, VCC-2 less than 8%, brain expansion during surgery.

CONCLUSION. Prognostic criteria identified by statistical analysis can be used to assess outcome prognosis at the early stages of medical care in patients with brain trauma associated with extracranial injuries. 

OBJECTIVES. A timely and accurate diagnosis of acute aortic disease is a prerequisite for a successful surgical treatment. Medical imaging techniques vary in their diagnostic capacity.

PURPOSE. The purpose was to assess the current role of endovascular techniques among other diagnostic and treatment modalities for patients with an acute aortic pathology.

MATERIAL AND METHODS. The results of endovascular diagnostic investigations performed in 472 patients with aortic pathology have been reviewed.

RESULTS. Detection of aorta pathology made 89.6% for aortic aneurysms, 14.1% for aneurysm ruptures, 93.1% for aortic dissection, and 100% for aortic injury. Dissections extended to the aortic branches were identified completely in 41.2 % of cases, and partially indentified in 17.6 %. Endovascular examinations allowed a more accurate evaluation of the aortic branches. Angiography measurements did not reflect an exact size of the aneurysm.

CONCLUSION. The angiography is less sensitive method than bolus contrast-enhanced CT and Doppler ultra­sonography and thus should be used only in the cases of suspected aortic-visceral fistulae, to assess the involvement of the aortic branches, the coronary arteryies, and the arteries contributing to spine perfusion, and also in the cases of suspected aortic injury in equivocal CT findings. Angiography should be used at the final stage of the diagnostic work-up in unclear cases and becomes more commonly considered as an endovascular surgical technique for stent-graft implantation, including that in the cases of acute aortic pathology. 

Abstract. Our results suggest that the combined use of optical coherent tomography (OCT) and fluorescence diagnosis helps to refine the nature and boundaries of the pathological process in the tissue of the colon in ulcerative colitis. Studies have shown that an integrated optical diagnostics allows us to differentiate lesions respectively to histology and to decide on the need for biopsy and venue. This method is most appropriate in cases difficult for diagnosis. 

Abstract. Contemporary algorithm of diagnostic examination of patients with suspected blunt cardiac trauma is presented. General aspects of monitoring and treatment of such patients are also discussed. 

Abstract. A rare case of right ventricle and pulmonary artery thrombosis in patient with antiphospholipid syndrome is described. Surgery stages and postoperative management have been demonstrated. It’s a matter of grate importance to unify the efforts of rheumotologists, cardiovascular surgeons, immunologists and detoxication specialists in order to determine an adequate treatment of antiphospholipid syndrome. 

Abstract. We report the use of rheolytic thombectomy in two patients with severe pulmonary embolism. In first case RT was performed as the second step in treatment of pulmonary embolism after systemic thrombolytic therapy. In second case systemic thrombolytic therapy was not performed because of extremely high risk of duodenal ulcer bleeding. Hemolysis and acute kidney injure with requirement of plasmapheresis and continuous venovenous hemofiltration was required in patient who received big volume of thrombectomy (500 ml). Rheolytic thrombectomy resulted in good angiographic and clinical effect in both patients.

Department of crisis conditions and psychosomatic disorders of Sklifosovsky Research Institute for Emergency Medicine: from creation to the present day, the stages and prospects of development.

Viktor S. Savelev. To the 85-th anniversary of the birth.

Boris D. Komarov. To the 85-th anniversary of the birth.

Источник: Cohen A.T., Spiro T.E., Buller H.R., et al. Rivaroxaban for Thromboprophylaxis in Acutely Ill Medical Patients // N. Engl. J. Med. – 2013. – Vol. 368. – P. 513–523.

Источник: Butcher K.S., Jeerakathil T., Hill M., et al. The intracerebral hemorrhage acutely decreasing arterial pressure trial // Stroke. – 2013. – Vol. 44. –P. 620–626.

Источник: Dumas F., Rea T.D., Fahrenbruch C., et al. Chest compression alone cardiopulmonary resuscitation is associated with better long-term survival compared with standard cardiopulmonary resuscitation. Circulation // – 2013. – Vol. 127. – P. 435–441.

Источник: Weninger P., Figl M., Spitaler R., Mauritz W., Hertz H. Early unreamed intramedullary nailing of femoral fractures is safe in patients with severe thoracic trauma // J. Trauma. – 2007 Mar; – Vol. 62, N. 3. – P. 692–696.

Источник: Clement H., Heidari N., Grechenig W., Weinberg A.M., Pichler W. Drilling, not a benign procedure: Laboratory simulation of true drilling depth // Injury. – 2012. – Vol. 43, N. 6 – P. 950–952.

Mikhail Izrailevich Perelman (20. 12. 1924 — 29. 03. 2013).

Nina Ivanovna Tikhomirova (14. 06. 1939 — 08. 02. 2013).

Galina Vasilevna Pakhomova (15. 12. 1937 — 12. 02. 2013).