Vol 22, No 6 (2016)

The article presents the results of studying techniques of evaluation of risk of transmission of viral infection under blood transfusion. The linguistic search was carried out in libraries of Russia and the USA concerning such notions as "risk", "infection" and "blood transfusion". It was established that estimate of risk of transmission of infection from donor to recipient is optimal in case of application of pre-valence, incidence and duration of "window period" of hemo-transmissible infections. These indices are to be included into system of examination and infection control of population and blood donors.

The study was carried out to implement comparative estimate of effectiveness of reperfusion therapy of myocardium infarction with elevation of segment ST under various organization of functioning of Z-Ray endovascular service in conditions of single clinic. The study included all patients with frontal myocardium infarction with elevation of segment ST (n=997) applied during two periods: 2003-2007 (n=446) and 2008-2011 (n=551). In period I, service was represented by department of x-Ray endovascular diagnostic and treatment of ischemic heart disease in the department of emergency cardiology. In mode of 8 hours’ workday 155 (34%) various types of x-Ray endovascular coronary interventions were implemented. At that, predominantly postponed (after 24-72 hours after inception of myocardium infarction) and at initially increased risk of death. In period II, service was represented by x-Ray surgery department of large profile functioning in twenty-four-hours mode. In these conditions, 400 (72%) x-Ray endovascular coronary interventions were implemented. The comparison group comprised patients with myocardium infarction and without x-Ray endovascular coronary intervention (n=442). The received data testifies advantage of x-Ray endovascular coronary service organized at the basis of emergency cardiology. It became model for successful application of x-Ray endovascular coronary interventions, development of new reperfusion, optimization of treatment process. The success of x-Ray endovascular coronary interventions under myocardium infarction with elevation of segment ST determines by combined characteristics of reperfusion by way of accelerated evolution of indices of ECG directly following restoration of blood flow in infarction-related artery. The conserved elevation of of segment ST is associated with worse prognosis. The angiography evaluation is subjective and it cannot reflect achievement of myocardial reperfusion. At the same time, at restoration of blood flow in infarction-related artery without convincing signs of reperfusion the prognosis is better than in case of conservative treatment.

The dynamics, characteristics of prevalence of HIV-infection combined with tuberculosis during last 5 years were investigated on the territory of the Republic of Karelia. The sampling of 107 medical records of patients with HIV-infection combined with tuberculosis during 2001-2014 was analyzed. It is established that against the background of wide prevalence of strains of mycobacteria of tuberculosis with multiple medicinal resistance in the region (primary multiple medicinal resistance - 46.5%) occurs late diagnostic of HIV-infection combined with tuberculosis in the Republic of Karelia (IV-V stage of HIV-infection - 72.9%). This situation, along with significant annual influx of patients with combined infection from the system of Federal penitentiary service of Russia into civil sector, facilitates further prevalence of this infection on the territory of the Republic of Karelia. The revealed characteristics of social structure and prevalence of combined infection require development of special programs of accurate monitoring of risk groups including measures of social support concerning persons without fixed address and persons leaving Federal penitentiary service of Russia into civil sector. With regard to frequent addition of other consecutive infections and atypical clinical radiologic picture of tuberculosis. frequent detection of multiple medicinal resistance of mycobacteria of tuberculosis it is necessary, for accelerated etiologic diagnostic, implementing molecular genetic diagnostic (Gene X-pert) in case of suspicion of occurrence of this disease in individuals with combined pathology (tuberculosis and HIV-infection).

The infusion therapy is the most important element of complex treatment of surgical patients at the stage of preparation to operation and narcosis directly during operation and also in post-operational period. Number of clinical situations dictates necessity of implementation of massive infusion therapy for urgent replacement of volume of circulating blood. In these cases, is extremely important comparison of velocity and volume of introduction of infusion mediums with capacity of human cardiovascular system adequately receive infusion load. This is an important clinical problem especially because of increasing in the structure of surgical patients of elder age and persons suffering with cardiovascular diseases. The article considers actual approaches to monitoring of stroke volume and cardiac output during infusion therapy in surgical patients under out-cardiosurgery operations.

The article presents publication review concerning the most typical affections of oral cavity in HIV-infected patients of children age. Among them are diseases of mucous tunic, salivary glands and also affections of solid tissues of teeth. The degree of their manifestation directly depends on immunity condition and viral load in blood. The effect of anti-retroviral therapy on condition of oral cavity in children with HIV-infection is demonstrated too.