[WORLD EXPERIENCE: HOW THE DEVELOPMENT OF THE PRINCIPLES OF ACADEMICIAN OF THE ACADEMY OF MEDICAL SCIENCES OF THE USSR N. A. SEMASHKO HELPED ICELAND TO CREATE ONE OF THE MOST EFFECTIVE HEALTHCARE SYSTEMS IN THE WORLD. PART 1. HISTORICAL OVERVIEW].

Annotation. The review article is devoted to the healthcare system of Iceland, which demonstrates some of the best indicators of public health in the world at relatively low costs for a developed European country. The successful experience of Icelandic healthcare is important for Russia, on the one hand, due to the proximity of this country to many Russian regions in terms of climatic and geographical location, demography and territorial development. On the other hand, the success of Iceland's healthcare is closely linked to the development of a model, in many ways similar to the Soviet model of Nikolai Semashko, which Russia has abandoned. The authors believe that Iceland's experience can be used in the modernization of regional healthcare systems in Eastern Siberia, the Far East and the Arctic, as well as Russian healthcare in general.

[WORLD EXPERIENCE: HOW THE DEVELOPMENT OF THE PRINCIPLES OF ACADEMICIAN OF THE ACADEMY OF MEDICAL SCIENCES OF THE USSR N. A. SEMASHKO HELPED ICELAND TO CREATE ONE OF THE MOST EFFECTIVE HEALTHCARE SYSTEMS IN THE WORLD. PART 2. PRINCIPLES FUNCTIONING OF THE ICELANDIC HEALTH SYSTEM].

Annotation. The review article is devoted to the healthcare system of Iceland, which demonstrates some of the best indicators of public health in the world at relatively low costs for a developed European country. The successful experience of Icelandic healthcare is important for Russia, on the one hand, due to the proximity of this country to many Russian regions in terms of climatic and geographical location, demography and territorial development. On the other hand, the success of Iceland's healthcare is closely linked to the development of a model, in many ways similar to the Soviet model of Nikolai Semashko, which Russia has abandoned. The authors believe that Iceland's experience can be used in the modernization of regional healthcare systems in Eastern Siberia, the Far East and the Arctic, as well as Russian healthcare in general.

[Use of H2-receptor blocker famotidine (quamatel) in anesthesiology for cardiopulmonary bypass surgery]. / Primenenie blokatora H2-retseptorov gistamina famotidina (kvamatela) v skheme anesteziologicheskogo obespecehniia kardiokhirurgicheskikh vmeshatel'stv s iskusstvennym krovoobrashcheniem.

The efficiency of perioperative therapy with quamatel (histamine H2-receptor blocker) for preventing gastrointestinal complications in cardiosurgical patients was evaluated. Quamatel was used in 68 cardiosurgical patients subjected to aortocoronary bypass surgery for coronary disease. Perioperative pH profile of the gastric contents was evaluated by a Gastroscan-5 acidogastrometer (Russia). The volume of gastric juice secretion was evaluated after induction anaesthesia, at the end of operation, and 6-8 h after the intervention. Quamatel was highly effective and well tolerated by cardiosurgical patients with concomitant gastrointestinal diseases during preparation to surgery. Use of quamatel for premedication, particularly in patients with gastrointestinal diseases, stabilized pH and decreased the gastric juice hypersecretion during the entire intraoperative and early postoperative period, thus preventing gastrointestinal complications. High therapeutic efficiency of quamatel and its good tolerance recommend it for cardiosurgical patients and to surgical patients of other profiles for prevention of gastrointestinal complications.

[Use of clofelin in the prevention of perioperative myocardial dysfunction in patients with ischemic heart disease]. / Ispol'zovanie klofelina dlia profilaktiki perioperatsionnoi disfunktsii miokarda u bol'nykh IBS.

The purpose of this study was to evaluate the possibility of using clofeline in anesthesiological protocol for myocardial revascularization as a drug preventing hemodynamic disorders and perioperative myocardial dysfunction. In group 1 (27 pts.) clofelin was used in premedication (150 micrograms at night on the eve of surgery and before the operation), group 2 (29 pts.) was control. Clofelin improved the stability of the cardiovascular system, decreased the incidence of hyperdynamic reactions, episodes of myocardial ischemia, and cardiac arrhythmia during surgery. Use of clofelin for premedication decreased the need in inotropic support during the postperfusion period from 49 to 37% and ensured a higher cardiac production during transfer from artificial to spontaneous circulation.

[The effect of current methods of induction anesthesia on the systolic and diastolic functions of the left and right heart in patients with ischemic heart disease]. / Vliianie sovremennykh metodov vvodnoi anestezii na sistolicheskuiu i diastolicheskuiu funktsiiu levogo i pravogo serdtsa u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Perioperative echocardiography and right ventricular volumic monitoring were used for more essential evaluation of different hypnotics in cardiosurgical patients. Our comparative study has shown that all the examined hypnotics induced no changes in systolic function of the left ventricle. Midazolam and propofol exerted minor depressive influence only on diastolic left ventricular function without significant fall of cardiac output. Etomidate moderately worsened diastolic and systolic right ventricular function with cardiac output decrease. The combined use of diazepam and ketamine provided excellent hemodynamic stability without negative effects on systolic and diastolic heart function.

[Multicomponent general anesthesia using analgesic butorphanol tartrate (beforal) in thoracic surgery]. / Mnogokomponentnaia obshchaia anesteziia s primeneniem analgetika butorfanola tartrata (beforala) pri torakal'nykh operatsiiakh.

Two schemes of anesthesia were used in 34 patients, making use of beforal, an agonist-antagonist of opioid receptors, as an analgesic component of total anesthesia during operations on the lungs. To improve neurovegetative protection, adrenomimetic clofelin was added to the Ist scheme and neuroleptic droperidol to the IInd. Use of beforal as an analgesic component of balanced total anesthesia in thoracal surgery in combination with both clofelin and droperidol ensured a sufficient level of anesthesiologic protection. Combination of beforal with clofelin, however, prevented hyperdynamic circulatory reactions at traumatic stages of the operation and intubation of the trachea and stabilized thermal homeostasis parameters, this indicating a more potent neurovegetative protection in this scheme of anesthesia.

[Paid medical services for the population of the USSR]. / Platnye meditsinskie uslugi naseleniiu SSSR.

The state of the network of cost-accounting medical facilities, their role and place in the system of medical paid services for the population are described. The work, economic and fiscal activities of Moscow cost-accounting medical facilities are analyzed. Measures aimed at further improvement of medical facilities providing paid services to the population are proposed.