[GENDER DIFFERENCES OF THE HEMOSTASIS POSTAGRESSIVE EARLY RESPONSE IN ACUTE NECROTIZING PANCREATITIS].

The study was performed in a group of 25 patients with acute necrotizing pancreatitis (mean age 46.2 ± 6.74 years). Gender differences of the hemostasis postagressive early response in the early stages of the disease were identified by comparing the procoagulant , anticoagulant and fibrinolytic blood activity of men and women suffering from pancreatitis. Compared to men, women showed higher concentrations of fibrinogen, D-dimer and VWF and smaller values marked trombokrit , antithrombin III, inhibitor of plasmin and protein C (p < 0.05). These results suggest a greater tendency to thrombi formation in women with acute pancreatitis; We believe that gender differences should be the subject of further research.

[Analysis of causes of pulmonary artery embolism hypodiagnostics at prehospital stage].

Aim of the study was to analyze causes of pulmonary artery thromboembolism (PATE) hypodiagnostics at prehospital stage. We compared clinical and electrocardiographic picture of acute period of the disease in groups of patients with diagnosed (n=61) and undiagnosed (n=22) PATE at prehospital stage. We also assessed retrospectively probability of PATE according to Revised Geneva Score. In 49 cases we analyzed dynamics of the acute period of PATE. The analysis showed that in more than 50% of cases hypodiagnostics of PATE was caused by similarity of observed clinical and electrocardiographical picture and that of acute coronary syndrome. There were no differences between groups in Revised Geneva Score.

[Healthcare quality assessment for children with severe injury in the Rostov region].

A two-level medical care quality control system for children with severe injury has been developed and tested in accordance with the guidelines of the Ministry of Health of the Rostov region. This control system functions within the existing regional system for departmental control of the Ministry of Health of the Rostov Region, which organizes medical provision of children with traumatic injuries. The first level is to exercise current control over informing about a child's admission to an intensive care unit or ward at a health care facility (HCF) of any level in the region; ambulance team going to a HCF in the region. The second level is a stepwise control that also includes two directions: to submit monthly information on died children under 18 years of age by HCF; annual reports by the principal anesthetists-resuscitators of the region's towns and districts, which includes an analysis of the results of treatment in children with severe injury.

[Age-related and etiological features of severe injury in children].

A comparative retrospective analysis of condition severity was made in different age groups: 61 road traffic injured children (Group 1) and 63 children with injuries of another etiology (Group 2) on admission. There no substantial differences in their condition severity: severe and extremely severe conditions were seen in 77.8 and 11.5% in Group 1 and 79.4 and 6.35% in Group 2, respectively. The age-related features of the pattern of traumatic injuries were established in relation to their etiology.

[Cases of West Nile fever in Novosibirsk region in 2004, and the genotyping of its viral pathogen].

Three cases of West Nile fever were registered for the first time in Novosibirsk region in 2004. The diagnosis was confirmed by revealing IgG against West Nile virus (three cases) and viral RNA (two cases). Sequence analysis of fragments of E protein gene showed that the virus belonged to Ia genotype.

[Better quality of medical care in patients with trauma before hospitalization]. / O povyshenii kachestva meditsinskogo obespecheniia postradavshikh s travmoi na dogospital'nom étape.

The psychological stability of traveling emergency care teams was under consideration. Reasons affecting, essentially, the human factor under the conditions of time deficit are presented on the basis of an analysis of the experience of the Research Center for Emergency Medical Care as well as on the basis of published data. The acting model of the dispatcher's service, whose activity is targeted at implementing a set of appropriate measures ensuring an optimal decision in a complicated professional situation, is described. It is concluded that a higher quality of medical care before hospitalization demands a balanced approach towards the discussed issue, which should be based on a comprehensive analysis of the positive experience accumulated in other countries and on searching for the mechanisms of adaptation of such experience to the principles existing in Russia.

[Mechanisms of acute respiratory insufficiency in patients with hyperglycemic coma]. / O mekhanizmakh ostroi dykhatel'noi nedostatochnosti u bol'nykh s giperglikemicheskimimi komami.

Basic parameters of pulmonary gas exchange, central and pulmonary hemodynamics, and colloid osmotic pressure were investigated in 31 patients in diabetic hyperglycemic coma over the course of intensive care. Pulmonary gas exchange disorders were observed in all patients in the presence of increased shunting of the blood in the lungs and disorders of transcapillary liquid exchange. On the other hand, we failed to obtain data indicative of an increase in the volume of extravascular water in the lungs. However, it does not rule out the possibility of iatrogenic disorders of gas exchange during noncontrolled rehydration.