[Methodological and practical problems in standardization in geriatrics].

The review covers methodological problems in developing the medical economic standards aimed at higher effectiveness and quality of work of geriatric departments. The main methodological problems are polymorbidity of geriatric patients and decreasing functional ability requiring a long-term medical and social rehabilitation. The standard in geriatrics is understood as an average minimum of medical and social services to be provided to a patient for the purpose to keep on or improve his functional ability.

[The characteristics of the anesthesiological support for surgical interventions in patients earlier operated on the heart].

The article presents an analysis of the authors' experiences with anesthesiological maintenance of operations on patients after revascularization of the myocardium, implantation of permanent cardiostimulant and heart value prosthesis. Main risk factors responsible for severe complications were found to be congestive heart failure, myocardial infarction which took place 6 months before the operation, certain forms of arrhythmias, unstable stenocardia, pronounced stenosis of the aortic valve, age older than 70 years, diabetes mellitus. The comprehensive preoperative preparing, choice of the adequate methods of anesthesia and maintenance of the up-to-date intraoperative monitoring create the conditions for a less risk of the surgical treatment.

[The prognosis and prevention of syncopal states and sudden death in patients with a complete atrioventricular block in disorders of permanent cardiac electrostimulation].

A total of 105 patients with implantable pacemakers were examined. Whether the pacemaker disconnection test can be used to predict syncopes in failure of permanent cardiac pacing was studied. The spontaneous ventricular activity was evaluated in 62 patients with acquired complete atrioventricular block (CAVB) and in 43 patients with artificial CAVB.

[The use of multiprogrammable cardiac electrostimulators for treating brady- and tachyarrhythmias in patients with ischemic heart disease].

Examined were 54 patients with different disorders of the cardiac rhythm with an implanted programmed electrocardiostimulator (ECS-200). The authors worked out methods and criteria of choosing individual regimes of electrostimulation, evaluated their effect on the severity of stenocardia and grade of circulatory insufficiency. The threshold frequency of stenocardia is of major significance in determining the optimal frequency of electrostimulation for patients with stable atrioventricular block.