Pub Date : 2021-09-30DOI: 10.24884/2072-6716-2021-22-3-53-60
A. Evseev, A. O. Girsh, S. S. Stepanov, M. M. Stukanov, R. V. Eselevich, P. Chumakov
The paper presents that the use of Ringer’s solution in the program of perioperative infusion therapy, compared with the use of an isotonic sterofundin solution, causes statistically significant adverse changes in the parameters of hemostasis, acid-base state and electrolyte composition, with the exception of potassium and sodium, venous blood. Also, the correlation analysis confirmed the relationship of significant adverse changes in the parameters of hemostasis, acid-base state and electrolyte composition of venous blood in patients when using Ringer’s solution in the perioperative infusion therapy program.
{"title":"Significant features of association of hemostasis, electrolytic and acidic alkaline composition parameters using different variants of perioperative infusion therapy","authors":"A. Evseev, A. O. Girsh, S. S. Stepanov, M. M. Stukanov, R. V. Eselevich, P. Chumakov","doi":"10.24884/2072-6716-2021-22-3-53-60","DOIUrl":"https://doi.org/10.24884/2072-6716-2021-22-3-53-60","url":null,"abstract":"The paper presents that the use of Ringer’s solution in the program of perioperative infusion therapy, compared with the use of an isotonic sterofundin solution, causes statistically significant adverse changes in the parameters of hemostasis, acid-base state and electrolyte composition, with the exception of potassium and sodium, venous blood. Also, the correlation analysis confirmed the relationship of significant adverse changes in the parameters of hemostasis, acid-base state and electrolyte composition of venous blood in patients when using Ringer’s solution in the perioperative infusion therapy program.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78258883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.24884/2072-6716-2021-22-3-65-70
D. V. Oblavatckii, S. Boldueva, S. V. Alekseeva, A. Sushkova, R. R. Mikhailov, S. A. Vinichuk
As known, a new coronavirus infection that causes acute respiratory distress syndrome can proceed in severe forms and lead to various complications, including acute cardiovascular events. This article describes a clinical case of the occurrence of acute myocardial infarction in a patient with a confirmed diagnosis of coronavirus infection. A peculiarity of this observation is the pathogenesis of the development of myocardial infarction, which is not directly related to atherothrombosis and differs from the classic type 1 myocardial infarction.
{"title":"Сlinical case of occurrence of myocardial infarction type 2 as a complication of new coronavirus infection","authors":"D. V. Oblavatckii, S. Boldueva, S. V. Alekseeva, A. Sushkova, R. R. Mikhailov, S. A. Vinichuk","doi":"10.24884/2072-6716-2021-22-3-65-70","DOIUrl":"https://doi.org/10.24884/2072-6716-2021-22-3-65-70","url":null,"abstract":"As known, a new coronavirus infection that causes acute respiratory distress syndrome can proceed in severe forms and lead to various complications, including acute cardiovascular events. This article describes a clinical case of the occurrence of acute myocardial infarction in a patient with a confirmed diagnosis of coronavirus infection. A peculiarity of this observation is the pathogenesis of the development of myocardial infarction, which is not directly related to atherothrombosis and differs from the classic type 1 myocardial infarction.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84538317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.24884/2072-6716-2021-22-3-4-11
V. V. Ruksin, O. V. Grishin, A. Miroshnichenko
The results of the study showed that during 3 years (2012–2014), the number of cases of uncontrolled arterial hypertension in two adjacent (control and main) emergency departments increased by 15.7% and 19.3%, respectively, and amounted to 95.2 and 95.4% of cases, respectively. It was proved that the increase in calls for emergency medical care in connection with uncontrolled arterial hypertension was due to an increase in multiple calls (23.5% and 26.4%, respectively) to the same patients, mainly of elderly senile age with comorbid pathology (78.4% and 84.2%, respectively). In the final comparative 3-year (2015–2017) study in two adjacent (control and main) emergency departments, it was shown that individually selected self-help with two-component combinations of antihypertensive agents was associated with a decrease in emergency medical care by 18.2%, due to uncontrolled arterial hypertension. The main indications, contraindications and methods of prescribing personalized self-help are proposed.
{"title":"Self-help for uncontrolled arterial hypertension","authors":"V. V. Ruksin, O. V. Grishin, A. Miroshnichenko","doi":"10.24884/2072-6716-2021-22-3-4-11","DOIUrl":"https://doi.org/10.24884/2072-6716-2021-22-3-4-11","url":null,"abstract":"The results of the study showed that during 3 years (2012–2014), the number of cases of uncontrolled arterial hypertension in two adjacent (control and main) emergency departments increased by 15.7% and 19.3%, respectively, and amounted to 95.2 and 95.4% of cases, respectively. It was proved that the increase in calls for emergency medical care in connection with uncontrolled arterial hypertension was due to an increase in multiple calls (23.5% and 26.4%, respectively) to the same patients, mainly of elderly senile age with comorbid pathology (78.4% and 84.2%, respectively). In the final comparative 3-year (2015–2017) study in two adjacent (control and main) emergency departments, it was shown that individually selected self-help with two-component combinations of antihypertensive agents was associated with a decrease in emergency medical care by 18.2%, due to uncontrolled arterial hypertension. The main indications, contraindications and methods of prescribing personalized self-help are proposed.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80252271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.24884/2072-6716-2021-22-3-61-64
R. A. Narziculov, A. A. Denisova, E. D. Ozerova
Paracetamol is non-narcotic analgesic and antipyretic of the central action from group of anilides, widely used in clinical practice. This drug has pronounced hepatotoxic effect which amplifies with alcohol. Paracetamol intoxication most frequently happens as a result of deliberate peroral intake of excessive doses of drug with a suicidal purpose. Undeliberate medicine poisoning is possible as a result of self-treatment.
{"title":"Аcute paracetamol intoxication","authors":"R. A. Narziculov, A. A. Denisova, E. D. Ozerova","doi":"10.24884/2072-6716-2021-22-3-61-64","DOIUrl":"https://doi.org/10.24884/2072-6716-2021-22-3-61-64","url":null,"abstract":"Paracetamol is non-narcotic analgesic and antipyretic of the central action from group of anilides, widely used in clinical practice. This drug has pronounced hepatotoxic effect which amplifies with alcohol. Paracetamol intoxication most frequently happens as a result of deliberate peroral intake of excessive doses of drug with a suicidal purpose. Undeliberate medicine poisoning is possible as a result of self-treatment.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73142830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.24884/2072-6716-2021-22-3-19-23
E. G. Skorodumova, V. Kostenko, E. Skorodumova, I. Gayvoronskiy, A. Siverina, A. Rysev
The aim of the study was to evaluate the systolic-diastolic ratio in patients with acute decompensation of heart failure against the background of the intermediate function of the left ventricle. This article is based on data from 585 electrocardiograms of 195 patients (98 males and 97 females), the average age was 64.6±14.8 years. By the level of the ejection fraction of left ventricle (LVEF), all patients were divided into three groups: with a reduced LVEF an intermediate LVEF and a preserved LVEF. As a result it was shown that in the groups of intermediate and low EF, when the systole of ventricles dominate over the diastole, but under the treatment ratio changed to the prevalence of diastole. In the preserved LVEF sample diastole dominates at all stages of the observation. Analysis of the ratio described may be useful for assessment of treatment effectiveness and coronary flow in patients with different types of LV function under acute heart failure decompensation.
{"title":"Systolic-diastolic attitude in patients with acute decompensation of heart failure","authors":"E. G. Skorodumova, V. Kostenko, E. Skorodumova, I. Gayvoronskiy, A. Siverina, A. Rysev","doi":"10.24884/2072-6716-2021-22-3-19-23","DOIUrl":"https://doi.org/10.24884/2072-6716-2021-22-3-19-23","url":null,"abstract":"The aim of the study was to evaluate the systolic-diastolic ratio in patients with acute decompensation of heart failure against the background of the intermediate function of the left ventricle. This article is based on data from 585 electrocardiograms of 195 patients (98 males and 97 females), the average age was 64.6±14.8 years. By the level of the ejection fraction of left ventricle (LVEF), all patients were divided into three groups: with a reduced LVEF an intermediate LVEF and a preserved LVEF. As a result it was shown that in the groups of intermediate and low EF, when the systole of ventricles dominate over the diastole, but under the treatment ratio changed to the prevalence of diastole. In the preserved LVEF sample diastole dominates at all stages of the observation. Analysis of the ratio described may be useful for assessment of treatment effectiveness and coronary flow in patients with different types of LV function under acute heart failure decompensation.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83934890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.24884/2072-6716-2021-22-3-24-31
E. Mazur, V. Mazur, R. M. Rabinovich, N. Kuznetsova, K. S. Myasnikov
The aim of this study is to identify the features of ST-changes in 12-leads surface ECG, which help to diagnose the right ventricular involvement in inferior myocardial infarction. The study included 145 patients with inferior myocardial infarction, the right ventricular infarction (RVI) was detected by echocardiography in 62 (42.8%) patients. ST segment depression in lead aVL was deeper than in lead V3 in 93.5% of patients with RVI. This feature is revealed in 4.9% patients with inferior myocardial infarction without RVI only. The sensitivity of this criterion for diagnosis RVI is 93.5%, the specificity is 95.2%, the predictive value of positive and negative results make up 93.5 and 95.2%.
{"title":"А new electrocardiographic criterion in diagnosis right ventricular myocardial infarction","authors":"E. Mazur, V. Mazur, R. M. Rabinovich, N. Kuznetsova, K. S. Myasnikov","doi":"10.24884/2072-6716-2021-22-3-24-31","DOIUrl":"https://doi.org/10.24884/2072-6716-2021-22-3-24-31","url":null,"abstract":"The aim of this study is to identify the features of ST-changes in 12-leads surface ECG, which help to diagnose the right ventricular involvement in inferior myocardial infarction. The study included 145 patients with inferior myocardial infarction, the right ventricular infarction (RVI) was detected by echocardiography in 62 (42.8%) patients. ST segment depression in lead aVL was deeper than in lead V3 in 93.5% of patients with RVI. This feature is revealed in 4.9% patients with inferior myocardial infarction without RVI only. The sensitivity of this criterion for diagnosis RVI is 93.5%, the specificity is 95.2%, the predictive value of positive and negative results make up 93.5 and 95.2%.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83909483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-30DOI: 10.24884/2072-6716-2021-22-3-12-18
V. V. Masljakov, O. Pavlova, A. Pimenov, A. G. Proshin, A. V. Poljako, A. A. Pimenova
The purpose of the study. Study the organizational aspects of providing primary health care for victims with the facial department of the skeleton as a result of traffic accidents. Materials and methods. To achieve this goal, a retrospective study was conducted. The work included victims of road accidents with damage to the facial part of the skull between the ages of 18 and 70 years. In total, 150 victims were included in the study between 2000 and 2019. Results of the study and their analysis. The study shows that injuries to the facial skeleton as a result of traffic accidents are relevant. As a result of the study, it was found that as a result of an accident, there is approximately the same number of closed and open injuries. At the same time, open injuries, which could be regarded as medium and severe, were identified in 45 (30%) cases. In addition, data analysis showed that in 30,7% of observations, first aid was provided by random witnesses and/ or relatives of victims who did not have the skills and necessary knowledge to provide such assistance. In addition, an additional 19,3 per cent of first aid was provided by staff of various services who have some knowledge and skills in first aid. This is due to the fact that in the first group, first aid was provided faster than in the second group. The lack of the necessary skills to provide first aid to victims with such an injury can be explained by the rather high percentage of errors, which in the first group amounted to 18,7%, while employees of various services showed good results in providing such assistance and errors were not noted. Key words: primary health care, damage to the facial skeleton, traffic accident.
{"title":"Оrganizational aspects of primary health care for personal skeleton damage caused by road traffic accidents","authors":"V. V. Masljakov, O. Pavlova, A. Pimenov, A. G. Proshin, A. V. Poljako, A. A. Pimenova","doi":"10.24884/2072-6716-2021-22-3-12-18","DOIUrl":"https://doi.org/10.24884/2072-6716-2021-22-3-12-18","url":null,"abstract":"The purpose of the study. Study the organizational aspects of providing primary health care for victims with the facial department of the skeleton as a result of traffic accidents. Materials and methods. To achieve this goal, a retrospective study was conducted. The work included victims of road accidents with damage to the facial part of the skull between the ages of 18 and 70 years. In total, 150 victims were included in the study between 2000 and 2019. Results of the study and their analysis. The study shows that injuries to the facial skeleton as a result of traffic accidents are relevant. As a result of the study, it was found that as a result of an accident, there is approximately the same number of closed and open injuries. At the same time, open injuries, which could be regarded as medium and severe, were identified in 45 (30%) cases. In addition, data analysis showed that in 30,7% of observations, first aid was provided by random witnesses and/ or relatives of victims who did not have the skills and necessary knowledge to provide such assistance. In addition, an additional 19,3 per cent of first aid was provided by staff of various services who have some knowledge and skills in first aid. This is due to the fact that in the first group, first aid was provided faster than in the second group. The lack of the necessary skills to provide first aid to victims with such an injury can be explained by the rather high percentage of errors, which in the first group amounted to 18,7%, while employees of various services showed good results in providing such assistance and errors were not noted. Key words: primary health care, damage to the facial skeleton, traffic accident.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88767027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-21DOI: 10.24884/2072-6716-2020-21-4-43-47
D. Maznev, S. Boldueva, I. Leonova, Е. А. Shloido, I. Kochanov, А. L. Kaledin, V. N. Ardeev
Despite the low injury of endovascular interventions, there are a number of complications that significantly worsen the prognosis of patients. The most unfavorable complications in patients with ST-segment elevation myocardial infarction during primary percutaneous coronary intervention are stent thrombosis, coronary artery perforation, tamponade, complications at the arterial access site, distal embolism, development of the "no-reflow", stroke. The article is devoted to the study of the frequency of these complications in primary percutaneous coronary intervention in combination with manual thromboaspiration.
{"title":"COMPLICATIONS OF PRIMARY PERCUTANEOUS CORONARY INTERVENTIONS COMBINED WITH MANUAL THROMBOASPIRATION IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION","authors":"D. Maznev, S. Boldueva, I. Leonova, Е. А. Shloido, I. Kochanov, А. L. Kaledin, V. N. Ardeev","doi":"10.24884/2072-6716-2020-21-4-43-47","DOIUrl":"https://doi.org/10.24884/2072-6716-2020-21-4-43-47","url":null,"abstract":"Despite the low injury of endovascular interventions, there are a number of complications that significantly worsen the prognosis of patients. The most unfavorable complications in patients with ST-segment elevation myocardial infarction during primary percutaneous coronary intervention are stent thrombosis, coronary artery perforation, tamponade, complications at the arterial access site, distal embolism, development of the \"no-reflow\", stroke. The article is devoted to the study of the frequency of these complications in primary percutaneous coronary intervention in combination with manual thromboaspiration.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90848760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-21DOI: 10.24884/2072-6716-2020-21-4-30-35
Y. Korneva, Yа. А. Rudenko
The article analyzes the autopsy reports of cancer patients who died in the Clinical Emergency Medicine Clinical Hospital in Smolensk in order to study the complications? Related to oncologycal disease in these patients. The complications of oncological diseases that doctors have to deal with in emergency hospitals and their specific manifestations depending on the location of the tumor are also analyzed.
{"title":"ANALYSIS OF COMPLICATIONS OF ONCOLOGICAL PATIENTS DIED IN THE EMERGENCY HOSPITAL","authors":"Y. Korneva, Yа. А. Rudenko","doi":"10.24884/2072-6716-2020-21-4-30-35","DOIUrl":"https://doi.org/10.24884/2072-6716-2020-21-4-30-35","url":null,"abstract":"The article analyzes the autopsy reports of cancer patients who died in the Clinical Emergency Medicine Clinical Hospital in Smolensk in order to study the complications? Related to oncologycal disease in these patients. The complications of oncological diseases that doctors have to deal with in emergency hospitals and their specific manifestations depending on the location of the tumor are also analyzed.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79929377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-21DOI: 10.24884/2072-6716-2020-21-4-70-76
V. Shalnev
The article highlights the modern approach to the thrombolytic therapy of acute myocardial infarction at the prehospital stage. The results of most significant clinical trials and registers in this area are discussed. Recent international and Russian clinical guidelines on thrombolytic therapy and pharmacoinvasive strategy in the treatment of acute myocardial infarction are also highlighted.
{"title":"THROMBOLYTIC THERAPY FOR ACUTE MYOCARDIAL INFARCTION AT THE PREHOSPITAL STAGE: CLINICAL GUIDELINES AND REAL PRACTICE","authors":"V. Shalnev","doi":"10.24884/2072-6716-2020-21-4-70-76","DOIUrl":"https://doi.org/10.24884/2072-6716-2020-21-4-70-76","url":null,"abstract":"The article highlights the modern approach to the thrombolytic therapy of acute myocardial infarction at the prehospital stage. The results of most significant clinical trials and registers in this area are discussed. Recent international and Russian clinical guidelines on thrombolytic therapy and pharmacoinvasive strategy in the treatment of acute myocardial infarction are also highlighted.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75812603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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