[Optimizing the prophylaxis of hospital-acquired deep vein thrombosis and pulmonary thromboembolism].

Aim: To reduce the number of preventable hospital-acquired venous thromboembolic events (HA-VTE) and to improve the quality of VTE prophylaxis at multiprofile hospital.

Material And Methods: A comprehensive approach to preventing HA-VTE was developed, which involved the global trigger tool method to assess adverse events, as well as the computerized clinical decision support system (CDSS) to prevent HA-VTE on the basis of relevant clinical practice guidelines, and HA-VTE registry.

Results: A total of 50 patients (15 men, 35 women; their median age was 70.

Decision support systems in clinical practice: The case of venous thromboembolism prevention.

Background: Today medicine is facing a "knowledge crisis" in that explosively expanding medical knowledge encounters limited abilities to disseminate new practices [1]. Clinical practice guidelines (CPGs) are intended to promote high standards of care in specific areas of medicine by summarizing best clinical practice based on careful reviews of current research. However, doctors are often short of time to study these documents and check their updates, have little motivation for strict adherence to them.

Effectiveness of one-stage microdiscectomy and radiofrequency denervation of intervertebral joints compared to microdiscectomy in patients with spinal disc herniation.

The article analyzes of the early and long-term outcomes in 113 patients who underwent surgical treatment for lumbosacral disc herniations. The first group of patients (n=32) underwent microdiscectomy in a combination with radiofrequency destruction (RFD) of the facet nerves. The control group patients (n=81) underwent microdiscectomy.

[Necessity of development of Russian vertebrologic registry].

Development of national and international registers for the most socially significant diseases is an important problem of contemporary medicine. Importance and priority of vertebrological register is explained by relatively young age of spinal neurosurgery as specialty, in which many questions concerning indications and optimal methods of treatment remain unsolved, and accumulated experience is quite limited. Nevertheless, vertebrology is on the way from opinions of certain experts to evidence-based scientific proofs.

[Novel method of analysis of risk of development of ischemic heart disease with the use of genomic and computer technologies].

Aim: to assess effectiveness of the use of modern methods of prognostication for assessment of risk of development of ischemic heart disease (IHD).

Material And Methods: We examined 131 patients with diagnosis of IHD verified by coronary angiography and 159 subjects of control group. Initial information on each patient included the following parameters: traditional risk factors, laboratory parameters, results of instrumental examination, genetic markers.

[D-dimer in diagnosis of acute thromboses of lower-limb deep veins].

Analysed herein is a potential role the D-dimer plays in diagnosis of acute venous thromboses of the lower limbs. The D-dimer blood plasma levels were determined in a total of 195 patients with either suspected or known acute thrombosis of the lower-limb deep veins. The D-dimer concentration was measured by the immunoturbidimetric method.

[Prediction of outcomes of surgical treatment of degenerative lumbar disk disease].

The paper focuses on algorithms of outcomes assessment of surgical treatment of the patients with degenerative lumbar disk disease. From 1997 to 2006 389 patients with discogenic lumbar pain were operated in the Medical Center of Central Bank of Russia. 185 patients underwent radiofrequency destruction of facet nerves, laser percutaneous lumbar discectomy was performed in 39 patients, microdiscectomy -- in 131, and decompression combined with lumbar spine stabilization -- in 31 cases.

[Transillumination-assisted phlebectomy with the help of the TriVex system in comprehensive management of varicose disease of lower-limb veins].

The present work was undertaken to evaluate a new minimally invasive method of surgical management of varicose disease by means of the TriVex unit. The method is based on transillumination of saphenous veins in an aqueous medium, which makes it possible to perform radical removal thereof form separate punctures under visual control with the help of a specially designed vein stripper. Transillumination-assisted phlebectomy (TIP) was compared with microphlebectomy (MPE) according to the Varady's technique.

[The role of genetic predisposition in the development of cardiovascular diseases (myocardial infarction, ischemic stroke, unstable stenocardia) and its interaction with conventional risk factors].

To assess the risk of cardiovascular events, the diagnostic effectiveness of molecular-genetic markers (polymorphisms in APOE, ACE (I/D) and MTHFR (C677T) genes) in combination with conventional risk factors has been studied. The prognostic effectiveness of common algorithms (the Framingham scale) is not sufficient for evaluation of risk factors for cardiovascular diseases. The combination of results of molecular-genetic testing with conventional risk factors allows to increase the predictability of cardiovascular risks.

[Analysis of efficacy of extensive systematic transperineal TRUS-guided cor biopsy of the prostate].

The paper presents the technique of extensive systemic transperineal TRUS-guided cor biopsy of the prostate. Some aspects of the patients' safety and quality of biopsy cores are considered. The analysis of TNM stages of the detected cancers (55 cases out of 142 patients who have undergone systemic biopsy) showed 65.

[Prognosis of the severity of acute pancreatitis by the neural network method].

For prognozing the character of the development of acute pancreatitis a neural network of the direct spread of the signal was developed with 15 inlets, 5 neurons of the latent layer and two outlets. The network was trained with the help of an algorithm of an inverse spread of the error. The sensitivity of the produced prognostic model was 100%, specificity at admission--70%, on the first day--80%, on the second and third day--90%.

[How to manage patients with atrial fibrillation in a general hospital].

Aim: To evaluate efficacy of use of technological charts (TC) in upgrading management and treatment safety in patients with atrial fibrillation (AF).

Material And Methods: Two groups of AF patients were compared: 196 patients treated before introduction of TC (group 1) and 431 patients managed according to TC technology (group 2).

Results: In group 2 treatment duration reduced from 26.

[Significance of parameters of automated reticulocyte analysis in diagnosis and evaluation of treatment outcome in B12-deficient anemia].

The results of examinations of reticulocytes in blood samples of 12 patients with the confirmed diagnosis of B12-deficit anemia and of 20 virtually healthy subjects (control group) by means of the GEN-S hematological analyzer (Beckman-Coulter) are described in the paper. Typical changes of the reticulocyte parameters are defined and their dynamics (with treatment by Vitamin B12) is studied. It was established that the additional parameters of the reticulocyte analysis, characterizing the quantity of immature reticulocytes and the fraction of immature reticulocytes, increase by 3 days before the total quantity of erythrocytes increases, which means that the above parameters can be used earlier as criteria in evaluating the treatment efficiency.

[Current technologies for enhancing efficiency of laboratory techniques].

The current approaches to promoting the efficiency of applying the laboratory tools were comprehensively analyzed. It was for the first time that the above issue was considered from the standpoint of a scientifically substantiated management scheme applicable to the laboratory examination volume and within the framework of the modern conclusive medicine. The problem can be solved through starting, in each clinic, an independent research project and through patient management (critical course--technological card) with respect to available technological and personnel resources.

Prevalence of malnutrition and 12-month incidence of mortality in two Sydney teaching hospitals.

Aims: The objectives of the present study were to determine: (i) the prevalence of malnutrition in two Sydney teaching hospitals using Subjective Global Assessment (SGA), (ii) the effect of malnutrition on 12-month mortality and (iii) the proportion of patients previously identified to be at nutritional risk.

Methods: A prospective study using SGA to assess nutritional status of eligible inpatients, from April to September 1997, with a 12-month follow-up to assess mortality. A total of 819 patients was systematically selected from 2,194 eligible patients.

[Development of navigation technologies for ambulatory surgery].

The article considers the main directions in the development of navigation surgical technologies allowing to decrease traumatic effects of certain operative interventions and to fulfill them in "one day" hospitals. The historical aspects of navigation surgery are given as well as a classification of the navigation interventions and examples of the newest of them used at the present time in the Medical Center of Bank of Russia.

[Technologies of ambulatory surgery].

The development of the outpatient surgery in Russia is thought by the authors to be very urgent if compared with the experiences of foreign clinics. In 1998 a Center of the outpatient surgery was set up in the Medical center of the Bank of Russia where the planned surgery treatment was performed in the regimen of the one-day hospitalization. The ultrastructure of the unit and problems of the outpatient surgery technologies are discussed.

[Current complex noninvasive diagnosis of parathyroid tumors].

The diagnosis of bulky formations of the parathyroid glands (PTG) has become possible since current high-resolution techniques of visualization, such as ultrasound study (USS), computed tomography (CT), magnetic resonance imaging (MRI), were introduced into practice. The presence of clinical and/or laboratory signs of hyperparathyroidism (HPT) is a signal to initiate a goal-oriented search for abnormal PTG formations. The complex diagnosis of HPT involves the methods of detecting osteoporosis ranging from routine X-ray study of the hand and foot to more in-depth techniques: dichromatic X-ray absorptiometry (DXA) and quantitative CT (QCT).