ABSTRACT
Presented in the article is a detailed description of a modified technique of minimally invasive surgical treatment of patients with atrial fibrillation - thoracoscopic radiofrequency fragmentation of the left atrium. This modification differs from the prototype GALAXY procedure by a significant increase of the 'quantitative' rather than 'qualitative' parameter of surgical aggression in relation to the left atrium. This technique results in creation of multiple transmural continuous closed lines of lesion to the left atrium and, consequently, a reduced risk of inadequate surgical treatment for atrial fibrillation. Besides the radiofrequency action on the wall of the left atrium, the protocol of the operation included destruction of the ligament of Marshall and resection of the left atrial appendage. An indication for performing this operation is the presence of various forms of atrial fibrillation.
Subject(s)
Atrial Fibrillation/surgery , Catheter Ablation/methods , Heart Atria/surgery , Catheter Ablation/instrumentation , Humans , Minimally Invasive Surgical Procedures , Thoracoscopy , Treatment OutcomeABSTRACT
The article provides description of modern status of the system of medical rehabilitation for servicemen of the Armed Forces on the level of health resort treatment. Authors give results of work analysis of military health resort institutions, concerning medical rehabilitation for military servicemen. Studied problem issues, defined main ways of medical rehabilitation organization improvement in health resort treatment institutions.
Subject(s)
Health Resorts , Military Medicine , Military Personnel , Rehabilitation , Humans , RussiaABSTRACT
The authors have conducted an environmental and hygienic evaluation of the prevalence of congenital anomalies in the Primorye Territory. It has been found that there is a considerable rise in congenital anomalies in children and adolescents, which is predicted for the coming 5 years. The prevalence of congenital anomalies in the region depends on the bioclimatic zone and environmental situation. The highest incidence of the pathology is observed in the children living in the coastal bioclimatic zone and in the adolescents in the critical environmental areas of the continental bioclimatic zone. A combination of sanitary-and-hygienic and natural climatic factors was found to influence the incidence of congenital malformations differently. The sanitary-and-hygienic parameters of an inhabitancy play a leading role (44.5-63.1%).
Subject(s)
Congenital Abnormalities/epidemiology , Congenital Abnormalities/etiology , Ecology , Environmental Pollution/adverse effects , Hygiene , Adolescent , Child , Child, Preschool , Climate , Humans , Hygiene/standards , Infant , Prevalence , Prognosis , Russia/epidemiologyABSTRACT
The advantages of xenon include its good hemodynamic profile and possible cardioprotective properties. The investigation was undertaken to study central hemodynamics, lung gas exchange, and blood oxygen-transporting function in xenon anesthesia in patients operated on under extracorporeal circulation (EC). Fifteen patients aged 41-69 years operated on for coronary heart disease were examined. The severity of the patients' baseline status corresponded to NYHA functional classes I to IV. The duration of an operation was 251 +/- 10 min; that of EC was 97 +/- 5 min; aortic ligation lasted 59 +/- 3 min. After induction of anesthesia with propofol via concentration-regulated infusion (CRI) and with fentanyl, delivery of xenon was initiated at concentrations of 47 +/- 1 to 52.5 +/- 1%, which was mixed with oxygen. Propofol CRI was used during EC. After the latter, xenon was inhaled at concentrations of 47.7 +/- 1 to 53.3 +/- 1%. The mean arterial pressure (BP(mean)), heart rate (HR), and cardiac index (CI) remained unchanged during xenon anesthesia in the preperfusion period. After EC during xenon anesthesia, CI significantly rose with a moderate increase in HR without inotropic support. BP(mean) was moderately, but statistically significantly decreased. Prior to and following EC, there were no changes in the values of blood oxygen-transporting function.
