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Acute pulmonary embolism (PE) is a relatively common vascular disease with potentially life-threatening complications. Right heart thrombi deteriorate the prognosis. Due to the known high lethality, such a clinical situation requires immediate diagnosis and treatment. With the existing different management options for intracardiac blood clots, the optimal one is still uncertain. The article describes the experience of therapeutic and diagnostic tactics in a patient with PE and thrombosis of two right chambers of the heart with a favorable outcome while the conservative approach was used.

The article is devoted to summing up the work of the Federation of anesthesiologists and reanimatologists of Russia and proposing the prospects of its development.

The labor activity of anesthesiologists and intensive care specialists has undergone significant changes in 2020. Admission of a large number of patients with a new coronavirus infection was accompanied by increased workload, changes in working and rest condi-tions, as well as new risks to the life and health of medical employee. A complex of measures to support healthcare professionals was adopted in the Russian Federation. Awareness of staff about these measures is the most important factor for effective health-care system functioning under a new coronavirus infection. © 2021, Media Sphera. All rights reserved.

In addition to operating injury in the pathogenesis of immunological and metabolic disorders after surgical interventions anesthesia plays an important role.to establish the relationship of the immune and metabolic disorders during various methods ofmulticomponent general anesthesia in conditions of laparoscopic cholecystectomy in patients with cholelithiasis.Under constant observation there were 68 women admitted to the hospital for surgical treatment of cholelithiasis. Patients were divided into 3 groups depending on multicomponent general anesthesia (halothane, propofol, sevoflurane). We determined the concentration of cytokines (TNFa, IL-la, IL-i/8, IL-4, IL-iRA, IL-2, IFNy), components of the complement system (C,, C3, C4, C, and C, factor H, C,-inhibitor), the activity of neutrophilsperipheral blood, the concentration of the products ofperoxidation, catalase, superoxide dismutase in blood plasma.The level of immune-inflammation and metabolic disorders in patients with cholelithiasis was higher in patients operated with the use of halothane. The use of sevoflurane has had the most positive effect on the studied indices.The close correlation between the investigated immune and metabolic parameters on the background of the use of different schemes of multicomponent general anesthesia in patients with cholelithiasis have let to the conclusion that in the conditions of use of sevoflurane has the least place a "tension" immune and oxidative status.

Advance formalization of a generalized fuzzy-logic mathematical model for forecasting and diagnosing cardiovascular complications is described. The model improves time of decision-making of anesthetist regarding the causes of complications and optimizes the perioperative period by prenosological prevention of occurring precursors of complications, reducing their total number and severity of clinical manifestations.

At patients with the verfied diagnosis have a cholelithiasis, transferred a laparoscopic holetsistektomy against the combined general anesthesia with muscle relaxants and artificial lung ventilation with use ofvarious anesthetics, the intraerythrocyte intensifi- cation of processes of peroxidation of lipids is established, and in a membrane of erythrocytes essential change of the contents and a ratio of the proteins and lipids responsible for structure, stabilization of a membrane and function of erythrocytes is revealed. Application of a sevoflurane, in comparison with propofol and, especially, a halothane, to a lesser extent influences structurally functional properties of erythrocytes that demands profile development ofpharmacological correction of the revealed violations.

To investigate the clinical and morphological features of uteroplacental blood flow during pregnancy in severe gestosis.One hundred and twenty-five patients with severe gestosis were examined. Scanning probe and electron microscopy with macro- and microelement analysis and transmission microscopy were used to study their placentas, umbilical cords, endometrium, myometrium, and maternal blood in severe gestosis.It is shown that circulatory disorders in the structural components of the examined tissues and organs, as well as changes in cytoarchitectonics and red blood cell functional properties may be a component of the trigger of disseminated intravascular coagulation, followed by impaired maternal and fetal vital activity.The investigation of the pathomorphological features of the microcirculatory bed in the mother-placenta-fetus system in gestosis has shown that possible methods of their correction should be further sought.

On the basis of the analysis of the results of treatment of 125 patients of the surgical profile, who were at critical state because of acute renal and hepatic failure, the high cost effectiveness of the extracorporeal methods of detoxication is shown.

1. Small additions of chromium and aluminum separately and together lower the scale resistance of binary and ternary alloys based on cobalt. The higher oxidation rate is due to the formation of cobalt oxide. With larger additions of these elements the oxidation resistance of the alloy increases sharply due to formation of spinels and Cr2O3 and Al2O3. 2. The addition of chromium to Co−Al alloys with ∼10% Al or more has no effect on the oxidation rate. 3. Aluminum (up to 11%) increases the scale resistance of Co−Cr alloys, which is due to the formation of CoAl2O4 and α Al2O3 in the scale, which slow down the diffusion of reagents through them.

It was established in experiments on 24 dogs with ligated interventricular branch of the left coronary artery that hexosophosphate (0.5 and 1 ml/kg intravenously) increases the collateral coronary blood flow and myocardial contractility against the background of a decrease in the lactate content in blood draining from the ischemic zone. Preliminary injection of hexosophosphate to rabbits increases the respiratory control in mitochondria from the ischemic myocardium. Drip intravenous hexosophosphate (100 ml) infusion to patients in the acute period of myocardial infarction reduced significantly sigma ST in precardiac leads and reduced the lactic acid content in venous blood. In 7.6% of cases hexosophosphate caused arrest or abatement of the pain syndrome.