The article presents: retrospective statistical analysis of crisis and emergency situations on the territory of Moscow for the years 2012-2016. Allocated in the territories of the attached health facilities as bases for the deployment of emergency response teams. Data on the use of sanitary helicopters in the connected territories. The planning system for effective medical support of activities with mass concentration of people of various types and scales, planning stages. Arrangement of medical forces.

In most cases drug-associated rhabdomyolysis is caused by the development of coma due to drug overdose or alcoholic intoxication. The course of disease can be complicated by acute kidney injury progress that leads to an increase in mortality. Timely diagnosis of disease and immediate treatment can prevent acute kidney injury or decrease its severity.

An important issue of safety in obstetrics is the management of postpartum hemorrhage, which is defined as estimated blood loss > 500 ml after vaginal birth, and > 750-1000 ml after a caesarean delivery. The blood loss >1500 ml is massive hemorrhage. We reviewed 143 cases of massive obstetric hemorrhages requiring laparotomy or embolization of uterine arteries. Embolization of uterine arteries was performed in 20 cases (13.9 %) and the reproductive function was maintained in all 20 patients. Other surgical methods were ineffective in 10 cases (8.1 %) and hysterectomy was performed. in the treatment of postpartum hemorrhage, it is necessary to use all available methods to stop bleeding with simultaneous adequate intensive therapy. Hysterectomy should be performed only if they are ineffective.

Creatine phosphate (CrP) plays a fundamental physiological role by providing chemical energy for muscle cell viability and activity. Numerous pathological conditions, such as acute ischaemia-repertusion, and cardiac deseases, are related to its deficiency. For these reasons, it has been used as a car-dio-protective agent in heart surgery and intensive cardiology. Many experimental and clinical trials with exogenous CrP have provided further interesting in formation on the pharmacological role of this molecule. This article gives a brief overview of the main characteristics of exogenous Cr P. Besides CrP s well known cell energy and function restoring properties, new evidence is emerging regarding its antioxidant and antiapoptotic properties. Use of CrP is well established clinically as an intraoperative and perioperative adjuvant in cardiosurgical, vascular and oncological procedures, and as an additional agent in cardiology therapy for acute myocardial infarction.

The purpose of the review: the consecration of modern tendencies and variants of anesthesia with arthroscopic operations on the shoulder joint. Basic provisions. In recent decades, the number of arthroscopic operations that are performed on the shoulder joint has increased. The introduction of arthroscopy increased the effectiveness of surgical intervention and reduced the number of complications. In connection with the development of arthroscopic technique of performing operations, the requirements for anesthetics of these interventions have changed. However, in the first place, the question of choice of perioperative analgesia patients arises both during the operation and in the early postoperative period. Perfection and introduction of new methods of perioperative analgesia for arthroscopic operations on the shoulder joint will increase the effectiveness of anesthesia, reduce the number of complications and increase patient satisfaction from the operation.

Neuraxial anesthesia is widely spread in the anesthetic practice of the Russian Federation. The use of neuraxial blockades frequently requires perioperative sedation. The most administered anesthetic drug for this is propofol. The use of propofol is associated with the development of a number of undesirable events. Since 2016 the use of dexmedetomidine in the anesthetic practice of the Russian Federation has been authorized. To compare the efficacy and safety of perioperative sedation with dexmedetomidine during the neuraxial anesthesia, a randomized prospective study was conducted. A total of 71 patients underwent routine surgery under spinal anesthesia with perioperative sedation with intravenous propofol and dexmedetomidine.

The aim of this study is to optimize the nutritional support of patients in the acute period of ischemic stroke during complex therapy using craniocerebral hypothermia (CCH). The study included 27 patients with ischemic stroke who were divided into two groups. In the 1st group (n = 14), along with the conventional complex therapy, CCH was used, in the 2nd one (control group), CCH was not used. The patients underwent a dynamic study of REE, RQ, daily protein losses. In the course of the study, a significant decrease in REE of about 17-19 % was observed in patients during the CCH when the temperature of the brain was reduced by 3-4 °C and the basal temperature was unchanged. Subsequently, the REE returned to baseline levels after warming. The protein loss decreased by 26-28 % even after warming and this reading remained lower than in the control group. These data obtained, should be taken into account when assigning nutritional support in patients with CCH in order to avoid hyperalimentation and hyperglycemia, which in turn may increase the amount of secondary damage to the brain.

The frequency of infectious complications of non-stretching hernioplasty is increasing everywhere; loss of the implant significantly reduces the patient s quality of life. The authors analyze the comparative results of treatment of 70 patients using the local negative pressure method and without it with a follow-up period of 1 month to 7.5 years. Decrease in the proportion of completely removed implants and the frequency of recurrence of the infectious process, using the local negative pressure method, infectious complications of non-stretching hernioplasty.

In one example, a patient with severe combined trauma, who was treated in the intensive care unit for at least 4 weeks, shows the formation of dysfunction of internal organs, with the development of multiple organ dysfunction syndrome. The main organs, is achieved in the development of MODS are the lungs, liver, spleen, kidneys, myocardium. Early detection of dysfunctions of internal organs and changes in the myocardium is an important trend in the search for ways to reduce mortality in patients with severe concomitant injury. An ultrasound in the dynamics shows a high degree of reliability with their morphological changes in the patients who died during the development of MODS 2-3 traumatic period in patients with associated trauma.