Emergency medicine in Russia.

Russia has undergone sweeping political and social reforms within the past 5 years. The economic and social reforms heralded by the "new openness" of perestroika have led to a restructuring of medicine as well. Changes include the emergence of "for profit" organizations and acute care facilities, the introduction of private health insurance, modifications in the medical education system, and realignment of health priorities with a new trend toward primary care.

[Detoxification in the combined intensive therapy of patients with multiple organ failure].

Studies of the influence of the UV irradiation of autologous blood (UVIAB) and hemosorption (HS) upon changes of indices of endogenous intoxication in patients with the syndrome of polyorganic insufficiency (SPOI) have shown that the isolated (without HS) UVIAB reduces toxemia and prevents the development of SPOI in patients without pronounced alterations of microcirculation. Using the UV irradiation of autoblood in patients with clinically marked alterations of the peripheral blood circulation increases toxemia at the expense of release of toxic products from the "disclosed" system of microcirculation. HS with the simultaneous taking the blood from the subclavian vein and abdominal aorta with using "Actilen" and return of the mixed blood into the peripheral artery interrupts and relieves the course of SPOI.

[Ultraviolet irradiation of the blood and hemosorption in the complex therapy of acute pancreatitis].

Pancreonecrosis and hemorrhagic form of the acute pancreatitis was treated in 76 patients by "traditional" methods which were added by UV irradiation of autoblood (in 12 patients), hemosorption (in 17 patients), UV irradiation of blood followed by hemosorption within 15-20 min (in 46 patients). Positive changes of some homeostasis parameters after hemosorption following UVI of autoblood allow to consider their successive use in intensive therapy of patients with acute pancreatitis to be a perspective method.