[Main military-and-clinical hospital in the system of medical support of the Russian Federation's Armed Forces].

Burdenko N.N. MMCH is the main hospital, a scientific-and-methodological center of medical service concerning prophylaxis-and-treatment spheres, the main clinical base of the State istitute of increasing doctors' qualification of RF MD and a military-and-medical faculty of the Moscow medical academy by Sechenov I.M. The hospital has the greatest experience of treatment of the wounded, sick and injured in all wars and armed conflicts with the participation of the Russian army. In the hospital's staff there is a unique flying surgical-and-reanimation laboratory "Skalpel" for urgent evacuation of the wounded from armed conflicts' centers. Almost all types of high technology medical care are provided in the hospital. About 6500 of the wounded and the sick obtain such treatment every year; 70-80% of the sick having treatment in the hospital are from the group of the most severe and complex patients. The hospital has the highest scientific and methodological level among hospitals of the Russian Federation's Armed Forces: 48 doctors and 141 candidates of medical science, those include 21 professors and 12 docents. It is the main base for new medical equipment and drugs testing to the interest of all medical service of the RF AF.

[Epidemiology and prophylaxis of septic infectious complications in patients from critical and intensive therapy surgical units].

AIM: To investigate efficacy of the extended complex of preventive and antiepidemic measures for reduction of nosocomial infections incidence in patients treated in critical and intensive therapy (CIT) surgical units. MATERIAL AND METHODS: From 2003 to 2005 CIT units of N.N. Burdenko Central Military Hospital conducted a study with participation of 200 patients aged 50 to 77 years after extended abdominal operations. The patients were divided into 2 groups. Group 1 (n = 100) received standard prophylaxis of infectious complications, group 2 (n = 100) received an extended complex of prophylactic and antiepidemic measures. First-line antibacterial therapy in all the patients included cephalosporines of the third generation and metronidasol. The extended complex included air decontamination with application of the system "Clean room complex"; prevention of nosocomial, particularly ventilator-associated pneumonia (VAP); prevention of catheter-associated sepsis; use of disposable sterile items. RESULTS: Group I patients developed sepsis in 30%, septic shock and polyorganic insufficiency (POI)--in 16% cases; lethality due to infectious complications was 13%. Gram-negative microflora was dominating. In group 2 sepsis was diagnosed in 22%, septic shock and POI--in 11%, lethality was 11%. CONCLUSION: The extended complex ofpreventive and antiepidemic measures significantly reduced the rate of severe infectious complications and related lethality. Among the agents of nosocomial infection the percentage of staphylococci and blue pus bacillus decreased while that of enterococci and E. coli increased. Contamination of the ambient air and CIT units reduced significantly.

[A revised classification of hypoxic conditions]. / Utochnenie klassifikatsii gipoksicheskikh sostoianii.

The precised classification of circulatory hypoxia described in the paper is principally different from those published earlier by that it discriminates between hypoxia preconditioned by impaired cardiac-muscle constriction, on the one hand, and hypoxia due to malfunctions of smooth muscles (SM), on the other hand. The genesis of SM malfunctions is predetermined by impaired interactions of serotonin with SM serotonin receptors. The clinical use of serotonin adipinat reduces the local organic and total-tissue hypoxia in different pathologies and provides for better treatment results. The mentioned precised classification can be used to gain more data on the tissue-hypoxia pathogenesis and to schedule the clinical-and-experimental research on the purpose-oriented basis.

[Prenozological changes in homeostasis indices in soldiers serving for a fixed period]. / Donozologicheskie izmeneniia pokazatelei gomeostaza u voennosluzhshchikh, prokhodiashchikh sluzhbu po prizyvu.

To reveal the prenosological changes occurred in soldiers' organism the dynamics of blood indices (laboratory-and-clinical method) and physiological system parameters (computer express reflexodiagnostics-programme "Diacoms") were studied. 192 soldiers serving for the fixed period were investigated; the mean age is 20.0 +/- 1.7. The season oscillations of insulin, cortizol, immunoglobulin M, adrenoreactivity levels were detected. The IgG increased level was observed in 38% soldiers and the increased circulating immune complexes--in 56%. The decrease in insulin secretion was also noted. Soldiers born in Moscow and those who were born in other places had different blood indices. Strain of blood indices was accompanied by the decrease in common functional state. The persons with uric acid increased level appeared to be more adapted to chronic stress situation. The results obtained show the necessity to correct the mentioned functional states in order to prevent the pathology development.