Sklifosovsky Journal Emergency Medical Care最新文献

{"title":"Sociological research to study the quality of emergency medical aid to the population of the Republic of Uzbekistan by the method of questionnaire","authors":"I. Minnullin, I. Barsukova, K. Anvarov, L. Mirvarisova, Z. S. Mirvorisova, Е. R. Minnullin, A. A. Akalaeva","doi":"10.24884/2072-6716-2023-24-2-4-10","DOIUrl":"https://doi.org/10.24884/2072-6716-2023-24-2-4-10","url":null,"abstract":"   In order to improve the system of emergency medical aid in the Republic of Uzbekistan, the issues of its availability and quality, as well as resources, technology and the results of the functioning of the system should be considered and analyzed taking into account the opinion of the heads of medical organizations, medical workers providing emergency medical care, as well as from the standpoint of study of patient satisfaction. To this end, a sociological study was conducted in 2021, the program of which included studying the opinions of the heads of medical organizations providing emergency medical care (stage 1) and employees of mobile ambulance teams (stage 2). Statistical and analytical methods were used. The data obtained allow us to note, in general, a positive assessment of the state of emergency medical care in the Republic of Uzbekistan by the heads of medical organizations. At the same time, according to the survey data, the medical workers themselves need to improve the working conditions of mobile teams, due to the significant volumes of non-core work, as well as the heavy work-load due to the high population density in the service area. The problems are exacerbated by the lack of informatization and automation of ambulance units, as well as the factor of “professional burnout” of personnel.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79649604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change of functional state in cardiological patients before and after coronoviral infection","authors":"R. Khabchabov, E. R. Makhmudova, A. A. Abdullaev, R. M. Gafurov, W. A. Islamova, M. A. Dzhanbulatov","doi":"10.24884/2072-6716-2023-24-2-16-24","DOIUrl":"https://doi.org/10.24884/2072-6716-2023-24-2-16-24","url":null,"abstract":"   Goal — was to assess the quality of life and the functional state of the cardiovascular system of patients who have had COVID-19, to outline the further tactics of recovery of the cardiovascular system.   Materials and methods. The study included 131 patients, men (n = 84) and women (n = 47), aged 41–76 years, with the presence of cardiovascular disease. Patients for a long time 4.4 ± 1.3 years, are under outpatient supervision in polyclinic No. 3, Makhachkala. Of the 131 patients included in the study: ischemic heart disease: angina pectoris I-II functional class was in n = 59 (45.0 %), arterial hypertension in n = 72 (55.0 %). All patients filled out the World Health Organization’s quality of life questionnaire, daily monitoring of electrocardiography, blood pressure, echocardiography and other types of examination was performed. The research was carried out in accordance with the norms and principles of the Declaration of Helsinki.   Results. After 2 months. after the COVID-19 illness, the survey showed that 62 patients (47.3 %) (p = 0.0026) were dissatisfied with the quality of life, before the illness, this figure was (28.3 %). Another 69 patients (52.7 %) are not satisfied with their state of health (p = 0.0048), against (30.4 %) — before coronavirus disease. Physical pain interferes with life — 48 patients (36.6 %) (p = 0.0019), before illness, only (24.5 %), and so on. Thus, the change in the status of quality of life “before and after” was statistically significant, p < 0.05. After 2 months. after coronavirus disease and discharge from the hospital, the daily monitoring of electrocardiography showed that in patients with exertional angina pectoris I-II functional class, ischemic and arrhythmic indicators were significant compared with the primary data p < 0.05. At the same time, the data of daily monitoring of electrocardiography in patients with arterial hypertension reached the indicators of patients with angina pectoris I-II functional class. The results of 24-hour monitoring of blood pressure before and after coronavirus disease showed that patients with increased numbers of systolic and diastolic blood pressure increased, with grade II arterial hypertension by n = 7, and with grade III. by n = 6. Hypertensive crisis began to be noted, almost every third patient had 16 (22.2 %), only 2 (2.8 %) patients were hospitalized with a stroke. Initial and after COVID-19, echocardiographic parameters were as follows, a significant decrease in left ventricular end-diastolic volume from 133.2 ± 4.2 to 127.0 ± 3.4, end-systolic volume from 77.3 ± 2.6 to 72.4 ± 7.01. The total ejection fraction significantly decreased in comparison with the initial data: from 49.6 ± 4.2 to 41.9 ± 7.3. There was a significant decrease in stroke volume from 61.7 ± 4.1 to 54.0 ± 5.8.   Conclusion. After analyzing the laboratory and instrumental data of the patients’ examination, we noticed that the real functional state decreased by a quarter in comparison with th","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76788945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A decade of problems and solutions (to the anniversary of the Department of emergency medical care and injury surgery of the Pavlov First St. Petersburg State Medical University)","authors":"I. Minnullin, N. V. Razumny, A. Sinenchenko","doi":"10.24884/2072-6716-2023-24-1-43-54","DOIUrl":"https://doi.org/10.24884/2072-6716-2023-24-1-43-54","url":null,"abstract":"The article summarizes historical materials on the establishment of the Department of Emergency Medical Care and Injury Surgery in St. Petersburg on the basis of the First St. Petersburg State Medical University named after Academician I.P. Pavlov. The main stages of its development are presented, the scientific potential and contribution to the development of emergency and emergency medical care to the population of the city are shown. Since 2012, the staff of the Department, in cooperation with the St. Petersburg Research Institute of Emergency Medicine, has contributed to the study and solution of scientific, practical, organizational and methodological issues in the field of emergency medical care in the Russian Federation. ","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83526104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular isovolumetric relaxation time is a potentially new marker of short-term and long-term prognosis in patients with acute heart failure’s decompensation and mid-range ejection fraction","authors":"E. G. Skorodumova, V. Kostenko, E. Skorodumova, A. Siverina, A. Rysev","doi":"10.24884/2072-6716-2023-24-1-75-79","DOIUrl":"https://doi.org/10.24884/2072-6716-2023-24-1-75-79","url":null,"abstract":"Purpose: to assess the role of left ventricular (LV) isovolumic relaxation time (IVRT) as a predictor of adverse outcome in acute decompensated heart failure (ADHF) against the background of intermediate ejection fraction (EF) of the left ventricle.Materials and methods. The study included 121 patients aged 37  to 85 years (mean age 67.2±2.5 years) with ADHF against the background of LV ЕF; 78 — male, 43 are fermale. In all patients, the time between the end of blood flow in the outflow tract and the beginning of blood flow in the inflow tract was determined, i.e., LV IVRT. According to this parameter, the whole group was divided into 3 samples: with an average LV IVRT (70–100 ms — 54 patients), increased (more than 100 ms — 15 patients) — or reduced LV IVRT (less than 70 ms — 52 patients).Results. The mean LV IVRT in group 1 was 87.5±6.4 ms, in group 2–106.4±9.7 ms, in group 3–55.3±4.1 ms. Hospital mortality (HM) in the entire sample was 5.3%, long-term (24 months) (LM) — 39.6%. The obtained results were subjected to correlation analysis: HM was characterized by a connection with LV IVRT (r= –0.295, p<0.05), but the dependence was inversely proportional. For LM, the correlation coefficient with LV IVRT was 0.519, p><0.05, which is typical for an average connection strength. Conclusions: 1. The value of IVRT in patients with midrange LV EF correlated negatively with the levels of both in-hospital and long-term mortality: low numbers of IVRT statistically significantly predicted an increase in mortality from all causes, while a decrease in mortality was observed at high values of IVRT. 2. In patients who are hospitalized for ADHF against the background of mid-range LV EF, it is advisable to determine the LV IVRT to assess the immediate and long-term prognosis of the disease. Keywords: heart failure, acute decompensation, time of isovolumetric relaxation of the left ventricle, prognosis> ˂ 0.05), but the dependence was inversely proportional. For LM, the correlation coefficient with LV IVRT was 0.519, p ˂ 0.05, which is typical for an average connection strength.Conclusions: 1. The value of IVRT in patients with midrange LV EF correlated negatively with the levels of both in-hospital and long-term mortality: low numbers of IVRT statistically significantly predicted an increase in mortality from all causes, while a decrease in mortality was observed at high values of IVRT. 2. In patients who are hospitalized for ADHF against the background of mid-range LV EF, it is advisable to determine the LV IVRT to assess the immediate and long-term prognosis of the disease. ","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83548335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"22nd All-Russian congress with international participation “Emergency Aid-2023”","authors":"A. Editorial","doi":"10.24884/2072-6716-2023-24-1-80-83","DOIUrl":"https://doi.org/10.24884/2072-6716-2023-24-1-80-83","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82896075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organization of emergency medical care in the Valdai district of the Novgorod region","authors":"V. Ratnikov, A. Povzun, A. Shcheglov, V. P. Gorelov, S. B. Klimshin, D. S. Ilyin, A. A. Boĭkov, A. V. Kremkov","doi":"10.24884/2072-6716-2023-24-1-70-74","DOIUrl":"https://doi.org/10.24884/2072-6716-2023-24-1-70-74","url":null,"abstract":"The average number of incoming calls determining the amount of load on the Valdai emergency care station (ECS) in the Novgorod region is estimated. Calculations of the required number of brigades were carried out, 3 models of the functioning of the ECS were proposed. Possible financing schemes for the work of the ECS have been identified. A comparison of the necessary costs for staff remuneration with two possible financing schemes was carried out. The proposals on the organization of the work of the ECS are formulated. ","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84192467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory support settings as indicator of the transportability of newborns","authors":"R. Mukhametshin, O. Kovtun, N. Davidova","doi":"10.24884/2072-6716-2023-24-1-60-69","DOIUrl":"https://doi.org/10.24884/2072-6716-2023-24-1-60-69","url":null,"abstract":"Purpose. To evaluate the predictive value of the parameters of respiratory support for newborn patients with respiratory insufficiency in assessing non-transportability.Materials and methods. The observational, cohort, retrospective study included data from 284 trips of the transport team to ventilated newborns from August 1, 2017  to December 31, 2018, a subgroup of transportable patients (n=244) and newborns recognized as untransportable due to the presence of respiratory insufficiency (n=40) was identified. The assessment and comparison of anamnesis, the status at the time of arrival of the transport team, intensive care, the parameters of respiratory support and its correction, monitored parameters, as well as assessments on scales — KSHONN, NTISS and TRIPS.Results. Тhe calculated respiratory parameters have a high predictive value for the non-transportability of newborns: the AUC ROC for the mean airway pressure is 0.858 [0.785–0.931], for the saturation index of oxygenation — 0.931 [0.893–0.970], for the SpO2/FiO2 ratio —  0.937 [0.901–0.973]. These indicators demonstrate significantly higher values of AUC ROC in comparison with the KSHONN scales (AUC=0.812 (0.742–0.882)), NTISS (AUC=0.848 (0.793–0.904)), TRIPS (AUC=0.802 (0.726–0.879)) scales. The high predictor value of the mean airway pressure and the saturation index of oxygenation for nontransportability remains high regardless of the need for catecholamine infusion.Conclusion. Mean airway pressure, saturation oxygenation index and SpO2/FiO2 ratio demonstrate a high predictive value for the patient’s non-transportability, exceeding the accuracy of the scales (KSHONN, NTISS, TRIPS).","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77585907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"X-RAY endovacular embolization in the treatment of ulcerate gastroduodenal bleeding","authors":"I. M. Musinov, A. E. Chikin, G. V. Sandursky, E. Y. Kachesov","doi":"10.24884/2072-6716-2023-24-1-55-59","DOIUrl":"https://doi.org/10.24884/2072-6716-2023-24-1-55-59","url":null,"abstract":"The use of targeted arterial embolization in the treatment of bleeding ulcers was accompanied by technical success in 97.6% of cases, clinical success in 95% of cases, bleeding recurrence occurred in 5% of patients, while repeated arterial embolization was used to eliminate it in 2.5% of cases. Delayed operations were performed in 8.3% of patients, mortality was 6.5%, which allows us to recommend transcatheter arterial embolization for the treatment of patients with ulcerative gastroduodenal bleeding. ","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77667206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment and prevention of atrial fibrillation and flutter: new approaches and unsolved questions","authors":"V. Shalnev","doi":"10.24884/2072-6716-2023-24-1-4-12","DOIUrl":"https://doi.org/10.24884/2072-6716-2023-24-1-4-12","url":null,"abstract":"The article highlights the modern understanding of etiology, epidemiology and pathogenesis of atrial fibrillation and flutter and their global burden as the most frequent form of supraventricular sustained tachyarrhythmia. The recent international and Russian national clinical guidelines on the treatment and prevention of atrial fibrillation are briefly discussed. The new antiarrhythmic drugs, presented in recent guidelines are also highlighted. The authors analyze their own experience in the treatment of paroxysmal atrial fibrillation with IC class drugs (propafenone) at the prehospital stage. ","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73862373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Сardiac manifestations of post-­COVID syndrome: tachycardia","authors":"A. Bagdasaryan, A. A. Sirunyants, D. V. Pukhnyak, Zh. A. Kamalyan, A. I. Remizova, N. Fedicheva","doi":"10.24884/2072-6716-2023-24-1-30-36","DOIUrl":"https://doi.org/10.24884/2072-6716-2023-24-1-30-36","url":null,"abstract":"Out of all the cardiac manifestations of post-COVID syndrome, tachycardia has been studied to a lesser extent, while almost all patients complain of palpitations.The purpose of the study is to reveal the incidence of post-COVID tachycardia syndrome in apparently healthy patients and to evaluate the effectiveness of ivabradine in this category of patients.Materials and methods. 48 patients revealing no comorbid pathology were examined 12 or more weeks after COVID-19. Materials of instrumental research methods, functional tests, quality of life before and during treatment with ivabradine were studied.Results. In all patients included in the study, against the background of an autonomic imbalance with a predominance of the activity of the sympathetic part and deterioration in quality of life, the syndrome of post-COVID tachycardia was diagnosed, and a positive effect of ivabradine on heart rate control was revealed.Conclusion. Tachycardia can be considered a marker of post-COVID syndrome in patients who were apparently healthy before coronavirus infection; it can manifest itself in POTS, NST, or their combination, as well as be accompanied by other cardiac arrhythmias including PVC, SVE, non-sustained SVT, and persistent form of AF. Ivabradine is able to control heart rate and level the manifestations of post-COVID tachycardia syndrome. ","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77708942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}