[Effect of analgesic sedation on the cytokine profile in victims with severe polytrauma].

The paper deals with the study of the impact of analgesic sedation on the parameters of spontaneous and induced production of cytokines and their plasma level in the severely traumatized. Posttraumatic analgesic sedation in victims with severe polytrauma has been found to alleviate the magnitude of a systemic inflammatory response, to reduce the plasma level of proinflammatory cytokines, and to maintain the spontaneous production of both pro- and anti-inflammatory cytokines by monocytic and macrophageal cells and the induced production of both pro- and anti-inflammatory cytokines in the immunocytes.

[The effect of Moradol (butorphanol tartrate) on immunity]. / Vliianie moradola (butorfanola-tartrata) na immunitet.

Two groups (with n = 5 in each group) were studied of essentially healthy volunteers by double-blind method. Those subjects in group 1 were administered placebo, those in group 2 received 0.1 mg/kg of moradole. In both groups, blood to be analysed was taken in fixed time intervals. An investigation designed to study immunological parameters involved correlation of results obtained before and after administration of moradole or placebo. Opioid agonists are endowed with marked immunity-inhibiting effect disappearing after the administration of naloxone. A hypothesis has been formed to the effect that those drug preparations endowed with agonist-antagonist activity toward opioid receptors fail to induce immunodepression, otherwise it is less pronounced than that of opioid agonists. The studies made allow a conclusion to be reached that administration of moradole is not associated with immunodepression.

[The clinico-physiological validation of the use of the endolymphatic route for antibiotic administration for preventing the translocation of intestinal microflora during the treatment of sepsis patients]. / Kliniko-fiziologicheskoe obosnovanie ispol'zovaniia éndolimfaticheskogo puti vvedeniia antibiotikov dlia profilaktiki translokatsii kishechnoi mikroflory pri lechenii bol'nykh sepsisom.

One of the main mechanisms of generalization of infection in purulent-inflammatory processes of the abdominal cavity, retroperitoneal space and pelvis minor is translocation of the pathogenic microflora of the intestine in the lymphatic system via regional lymphatic nodes with subsequent rupture into the systemic circulation. Endolymphatic administration of antibacterial agents into the peripheral lymphatic vessel favours saturation of the reticuloendothelial structures of the lymph nodes by the antibiotic agent that increases their barrier function and, thus, prevents generalization of the infection and development of polyorganic insufficiency.

[Effects of interferon preparations on the course of Salmonella infection (experimental and clinical studies)]. / Vliianie preparatov interferona na techenie salmonelleznoi infektsii (éksperimentalnoe i klinicheskoe issledovanie).

The effect of type I interferons on the process of experimental salmonellosis in mice and rabbits, as well as their effect on salmonellosis in patients was studied. It was shown that homologous interferon increased the animal survival rate, activated bactericidal activity of the phagocytic cells and increased elimination of the infectious agents from the host. The complex of the etiotropic and pathogenetic treatment of 32 patients with salmonellosis included human leukocytic interferon, leukinferon. It was administered intramuscularly in a dose of 1 x 10(4)-2 x 10(4) IU: three injections at intervals of 48 to 72 hours (the treatment course). The course was repeated 10 days after the last injection of the first course. Addition of leukinferon to the routine scheme of the medicinal treatment of salmonellosis provided recovery of all the patients without complications or appearance of the bacteria carriers (the observation period of more than 3 years).

[The interaction of moradol (butorphanol tartrate) and flormidal (midazolam) in the patient's body]. / Vzaimodeistvie moradola (butorfanola tartrata) i flormidala (midazolama) v organizme bol'nykh.

Twenty five female patients (3 groups) operated on for cholelithiasis without premedication have been examined. In patients of group F an effective flormidal dose (EFD) causing an unconscious state upon intravenous injection by a measuring device has been determined. Due to an insufficient sedative effect of moradol it was impossible to determine an effective moradol dose (EMD). In group M+F right after intravenous administration of a standard moradol dose (SMD) flormidal infusion was begun, as in patients of group F. EFD after moradol injection (EFMD) was determined. Making proportions with known EFD, EFMD and SMD values, EMD was calculated. Upon intravenous administration of the calculated EMD by a measuring device the sedative effect was superficial in all the patients of group M and it was impossible to achieve an unconscious state. The interaction of moradol (butorphanol tartrate) and flormidal (midazolam) in the patients' body is of synergic nature.

[Hemosorption in the combined treatment of patients with acute exogenous poisonings]. / Gemosorbtsiia v kompleksnom lechenii bol'nykh s ostrymi ékzogennymi otravleniiami.

The authors analyze their experience with 247 hemosorptions in 163 patients with acute exogenous poisonings. Indications and contraindications to hemosorption in these patients are described. Methodical aspects of hemosorption are described: vascular approaches, apparatus, prehemosorption care, regimens of hemosorption. Hemosorption may be associated with hemodialysis, hemofiltration, ultraviolet irradiation of the blood.

[Changes in autonomic homeostasis during anesthesia induction in patients operated on for congenital cleft palate]. / Izmeneniia vegetativnogo gomeostaza pri vvedenii v narkoz u operiruemykh po povodu vrozhdennogo nesrashcheniia neba.

Variation pulsometry was used to study vegetative homeostasis changes over the course of induction anesthesia and tracheal intubation in children operated on for palatal clefts. The same premedication scheme was employed in all the patients. The same neuroleptic doses were administered in induction anesthesia. Induction anesthesia parallel with electroanalgesia with an Electronarcol-1 apparatus helped reduce the promedol dose necessary for adequate anesthesiologic protection from 1.2-1.4. to 0.2-0.4 mg/kg. This was associated with the minimal changes in autonomic nervous system functioning, evidencing the efficacy of electroanalgesia in induction anesthesia for this patient population.

[Intrapleural anesthesia following thoracic surgery and in chest trauma]. / Vnutriplevral'noe obezbolivanie posle torakal'nykh operatsii i pri travme grudi.

The analgesic effect of intrapleural administration of local anesthetics (lidocaine, trimecaine, azocaine) has been studied in 180 patients after thoracic surgery and with chest trauma. The effect was assessed on the basis of subjective (visual analogue 10-score scale) and objective findings (hemodynamic parameters, spirograms, ECG). In control patients analgesia was performed by intramuscular promedol administration. It has been shown that fractionated intrapleural administration of local anesthetics is an effective and safe analgesic technique after thoracic surgery and in chest trauma.

[Clinical picture and treatment of acute thallium poisoning]. / Klinika i lechenie ostrogo otravleniia talliem.

The authors report results of treatment of 16 patients whose disease was caused by premeditated poisoning with thallium fluoride. The first signs of the disease appeared in 5 patients 30-38 hours and in the remaining 2-4 days after ingestion of poisoned food and were manifested by dyspepsia, leg pain. Then neurological symptoms of polyneuritis and encephalomyelitis prevailed. Within 1-3 weeks alopecia, xeroderma, herpetic phenomena appeared. Most patients showed disorders of the psycho-emotional sphere (intoxication encephalopathies of anxiety-paranoia type). Severe grades of thallitoxicosis were marked by involvement of the myocardium, liver and kidneys. Excretion of the nucleus is slow: with the urine (45%), with feces (55%). For correct diagnosis and for solution medical forensic problems examination of the content of thallium in the blood, urine, feces and hair is of importance. Treatment tactics are described in detail.

[Clinical use of long-term nasotracheal intubation]. / Klinicheskoe ispol'zovanie dlitel'noi nazotrakheal'noi intubatsii.

Clinical data are presented on prolonged (3 to 63 days) nasotracheal intubation in 159 patients performed for controlled lung ventilation and for maintenance of upper respiratory ways patency in spontaneous respiration. The advantages and disadvantages of nasotracheal intubation as compared to tracheostomy and orotracheal intubation are analysed. The indications for delayed tracheostomy, ways of prevention of complications of prolonged nasotracheal intubation and a method for maintenance of intubation tube patency are suggested.