A pulmonologic healthcare system was organized at the Altai region including a regional pulmonology center, pulmonology department of city hospitals, referable pulmonology wards and asthma-schools working as outpatient departments for asthmatic patients. A new structure of a regional pulmonology center was created which involves an intensive care unit for pulmonary pathology and respiratory support and a regional asthmacenter with ambulatory working mode providing oxygen therapy at home. Due to this, early-stage detection of respiratory pathologies was improved, a number of admissions to hospitals was reduced for certain diseases and a mortality of severe lung pathologies was decreased.

The authors carried out a retrospective analysis of clinical efficacy of streptokinase and alteplase (actilyse®) in patients presenting with high- and intermediate-to-high risk pulmonary artery thromboembolism (PATE) who were discharged from hospital after appropriate treatment performed. Of the total number of the treated patients, we formed 2 groups comprising 20 patients each, receiving alteplase (group 1) and streptokinase (group 2). The patients were comparable by the main clinical characteristics, predisposing factors, severity of pulmonary artery thromboembolism (PATE) and duration of treatment. Efficacy of thrombolytic therapy assessed clinically and instrumentally did not differ. However, by the stratified risk and frequency of PATE relapses, the condition of patients receiving alteplase turned out to be more severe. Based on the obtained results, a conclusion was made that actilyse is a drug of choice for treatment of patients with PATE.

The purpose of the study was to optimize the technique of removing the trunk of the great saphenous vein (GSV) in patients over 60 years. The study included a total of eighty-five patients aged over 60 years and presenting with primary varicose veins of the lower limbs and undergoing operations performed on the superficial venous system, including all stages of classical phlebectomy - crossectomy, stripping of the GSV, removal of tributaries and ligation of incompetent perforant veins. The patients were divided into two groups: the Study Group (n=44) patients endured removal of the GSV with the use of the technique of temporal tamponing of the canal, while in Group Two patients, composing a comparison group (n=41), the GSV was removed without the use of a tampon. The groups of the patients were comparable by the main characteristics, as well as by the CEAP class and the types of the operations performed. The results of treatment were studied clinically with the use of the Venous Clinical Severity Score (VCSS). In the Study Group patients, the average VCSS score decreased from 1.52±0.11 to 0.47±0.05 (p=0.007) and in the Comparison Group from 1.21±0.11 to 0.85±0.06 (p=0.028). In the remote terms after the operation, in the Study Group patients the average VCSS score appeared to be 2 times lower than in the control group, amounting to 0.47±0.05 and 0.85±0.06, respectively (p=0.007). A conclusion was drawn that in surgical treatment of varicose veins in elderly and aged patients while removing the grate saphenous vein, it is appropriate to use the technique of temporary tamponing of the canal, which is associated with better results in the remote period as compared to the traditional stripping.

The aim of the study was to evaluate reproductive health of descendants of people who experienced effects of adverse environmental factors, such as radiation and chemical contamination (the descendants themselves were unaffected by these factors). Reproductive health of women was assessed by mathematical modeling. Factors of greatest importance for the health status of the descendants were distinguished among the 76 ones studied. It was shown that reproductive health of the subjects descending from the people exposed to radiation deteriorated more significantly than of those whose ancestors were affected by chemical factors.

The use of cryosupernatant plasma fraction in the complex treatment of acute lung abscess and gangrene in comparison with a standard conventional complex treatment reduced the number of complications by 20 % and the number of methods of evacuation of purulent fluid from the cavity by 28 %, increase the level of AT III by 11%.Using cryosupernatant plasma fraction in the complex treatment of acute lung abscess and gangrene has reduced according to the number of bronchoscopy in patients with purulent phlegm in the bronchial tree by 36.9 %, from the lack of it in the bronchi by 56.8 %, increase the number of patients with a pale pink bronchial mucosa by 30.1 %, while those with diffuse edema and hyperemia 2 tbsp. By 20.0 %, with edema and diffuse hyperemia 3 tbsp. By 9.9 %.Achieved the following outcomes in the treatment of acute pulmonary abscess and gangrene : the main group of patients recover fully observed more frequently by 24.3 %, the transition process in the chronic process at least 12 % lower than in the comparison group.

This retrospective study included 64 patients divided into 2 groups. Group 1 was comprised of 34 patients with systemic scleroderma and signs of interstitial lung lesions (X-ray diagnostics), the control group included 30 patients with scleroderma alone. They were examined by general clinical, biochemical and immunological methods, ECG, Echo-CG, capillaroscopy, standard chest X-ray, spirometry, ultrasound studies of internal organs, oesophageal, gastric and duodenal endoscopy. It was shown that systemic scleroderma with signs of interstitial lung lesions is more frequently accompanied by clinical (cough, dyspnea, bilateral inspirational crepitation) and functional (reduced lung vital capacity) pulmonary disorders. Also, these patients have "pursed mouth" appearance, their skeletal muscles and blood circulatory system are involved in the pathological process which accounts for arterial hypertension and mitral valve sclerosis (Echo-CG), reduced hemoglobin level hypergammaglobilinemia, IgA variations, and leukocyturia.

The authors studied the seasonal cyclicity of the thrombotic and embolic process in the veins of the upper and lower extremities, as well as acute ascending varicothrombophlebitis in the great and small saphenous veins over eleven years. The study included a total of 1,513 patients. Of these, 593 (39.1%) presented with arterial ischaemia and 920 (66.9%) patients had ascending thrombophlebitis. The obtained findings showed the seasonal cyclicity of the thrombotic and embolic processes in the peripheral arteries and superficial veins. The maximal number of arterial thrombi was revealed in winter and that of embolisms and ascending varicothrombophlebitis in the spring period. No seasonal dependence for severe grade arterial ischaemia (category III according to the TASC II classification) was revealed.

The aim of the study was to determine the efficacy of plasmapheresis with replacement of plasma loss with cryosupernatant fraction of plasma in combination treatment of acute pulmonary abscess and lung gangrene. The study included a total of 210 patients assigned into two groups. The first group (n=150) received conventional treatment with fresh frozen plasma. The second group (n=60) received the combination treatment with plasmapheresis and replacement of plasma loss with cryosupernatant fraction of plasma. Data of the study showed that the combination treatment with plasmapheresis and replacement of plasma loss with cryosupernatant fraction of plasma increased the level of antithrombin III (by 10.6%) and decreased the numbers of complications (by 20%), pulmonary drainages (by 34.7%), and pulmonary decortications with subtotal parietal pleurectomy (by 3.3%). The number of patients who achieved a full recovery increased by 19.0% in comparison with the control group.

The study aimed to assess the efficacy of the adopted principles of the treatment of lung abscess without sequestration on the example of 2397 patients. Treatment led to the complete recovery in 1731 (72,2%) patients. The 614 (25,6%) patients showed the chronization of the process and 52 (2,2%) died. The surgical treatment of lung abscess without sequestration (performed in cases of uneffective conservative treatment) led to the complete recovery on 45.7% more often and the chronization of the process was registered on 26.8% more seldom, whereas the lethality rate was higher than by conservative treatment on 8%.

There are the results of a comprehensive clinical examination of 112 women of childbearing age who are second generation descendants of those who were in the area of radiation exposure over 25 ED cSv. Incidence and factors leading to chronic inflammation of pelvic organs were studied. Immune status was evaluated by studying of subpopulation of immune cells in peripheral blood and levels of basic inflammatory cytokines. High incidence of the pelvic organs inflammatory diseases in women second-generation offspring due to disturbances in the complex chain of immunocompetent system was defined.

AIM:to study clinical and functional impairments in the digestive system in patients with chronic obstructive pulmonary disease (COPD), including that in the presence of coronary heart disease (CHD).SUBJECTS AND METHODS:Clinical and functional impairments were analyzed in 1104 patients. Of them, 402 patients had COPD (Group 1); 459 had COPD concurrent with angina on exertion (Group 2); 243 had CHD (Group 3). All the patients suffered from cardiovascular diseases.RESULTS:In patients with concomitant pathology, chronic gastritis is a most frequently detectable disease of the digestive system (62.3%), gastroenterological complaints being insignificant. The rate of Helicobacter pylori infection was 68.2% (in Group 2 patients) to 83.7% (in Group 1). A morphological study indicated that in concomitant pathology the number of patients with signs of atrophy increased; at the same time there were microcirculatory disorders in the gastric mucosa. Ulcerative disease was diagnosed in one third of the patients, a gastric ulcerative process being more commonly located in the stomach. Gastroesophageal reflux disease was detected in 206 (51.2%) patients in Group 1, in 267 (58.2%) in Group 2, and in 113 (46.5%) in Group 3.CONCLUSION:By resulting in the mutual burden of the disease, the high rate of concomitant digestive pathology necessitates additional examination and mandatory medical correction in patients with