The review of the literature devoted to implanted cardioverters-defibrillators. The history of introduction of these devices in clinical practice is stated. Results of the large randomized researches are quoted. Indications, contraindications and efficiency of the implanted cardioverters-defibrillators in prophylaxis of sudden cardiac death are suggested.

The modern state of classification of the iatrogenias and their place in lifetime and posthumous diagnoses is considered. On the basis of the data of the literature and own material the conclusion about inadequate diagnostics of the iatrogenic pathology in the Medical Institutions of the Russian Federation is done. Modern classification of complications of medical, diagnostic and preventive manipulations is resulted. It is judged the necessity of development of uniform federal criteria of diagnostics and iatrogenic rubricating.

The paper is devoted to the review of pre-hospital trombolitic therapy system in Vladivostok city. The basic elements of introduction are "...analysis — training — standards — equipment — monitoring system — motivation — execution — analysis...". The concrete actions on each element of system, ways and variants of achievement of the purpose are described. The important links are early trombolisis with ambulance team and collaboration with special cardiologic unit of city hospital No. 1. The example of successful introduction can be served with decrease of mortality rate of the patients with STEMI in Vladivostok from 21.7% (2001-2005) up to 15.0% (2006). The necessary conditions for a successful beginning and developing of activity also are determined.

On a material of 97 cases the reaction on surgical stress is investigated depending on a technique of anesthesia. It is shown, that the multimodal approach to anticipatory antinociceptive protection, including the use of the prolonged epidural morphine analgesia in a combination with ketoprofenom, allows to provide the most adequate anesthesia, creates favorable conditions for functioning of the cardiovascular and respiratory systems and it is characterized by small changes of a level of the stress mediators.

Mortality in patients with AF is twice increased in comparison with those un sinus rhythm. The possibility of atrial fibrillation prevention in patients with permanent pacemakers is analyzed in comparison with the mechanism of atrial fibrillation onset. Patients with bradicardiac and ectopic mechanisms of atrial fibrillation induction seem to be optimal candidates for pacemaker therapy. Right ventricular pacing was independent predictor of arrhythmic events.

The first data analysis showed that CABG did not impact on elimination of dyssynchrony and improve echo data in early postoperative period and follow up. Temporary biventricular pacing improves haemodynamic, echo data and also decrease dyssynchrony signs in early postoperative period.

The analysis of efficiency of the automatic implanted cardioverters-defibrillators at 32 patients with risk of sudden cardiac death (ischemic heart disease, dilatation cardiomiopathy, etc.) is done. Triggering of devices has been fixed at 85.7% of patients at which implantation was a measure of secondary prophylaxis. From primary prophylaxis group of sudden cardiac death (7 cases) triggering has been fixed in 1 case (14.3%). Thus, implantation of the cardioverters-defibrillators as a measure of secondary prophylaxis is absolutely justified.

In this clinical research the physiological mechanisms influencing the system of hemostasis in a context of a level of compensation of physiological functions are analyzed. In adaptable aspect the processes influencing aggregation, disaggregation, fibrinolytic systems, vascular and platelet parts are shown at isolated and complex interventions on various abdominal organs.

The retrospective analysis of 328 cases of esophageal-duodenal bleedings at patients in the age of 16-85 years is done. To stop the bleeding in 111 cases authors used endoscopy with injection into the source of bleeding (ulcer) of 0.1% solution of epinephrine. Relapse of a bleeding is registered at 28 patients who underwent urgent surgery. It is judged, that endoscopic injection at high risk of relapse of a bleeding is a temporary measure, and a final stop of a bleeding should be surgical. There is a discussion about combined endoscopic intragastric methods of stop of bleeding which can provide a final hemostasis.

On a material of supraventricular tachyarrhythmia at 21 children in the age of from 2 days till 1 year of age the indications and contraindications to medical therapy, radio-frequency ablation and to electropulse treatment are suggested. In 12 cases supraventricular tachycardia has been stopped by conservative methods. In 3 cases authors used radio-frequency ablation and in 6 — electropulse therapy. The shown results are good. It is concluded, that the individual approach is necessary for treatment of the tachyarrhythmia in children, thus use of the complex of the therapeutic and surgical methods used at adults is allowable.

The comparative analysis of the structure of infectious complications in the early postoperative period at 184 patients is submitted. Myocardial revascularization was carried out on working heart and on by-pass. The received results allow to achieve the insignificant (on 3%) reduction of the infectious complications after myocardium revascularization in the 1st group of patients. This fact allows to believe that the postoperative period, short and long-tern follow-up after surgeries on working heart are more favorable.

The article is devoted to clinic, pathogenesis and treatment of the nephrotic crisis. The features of each stage of the nephrotic crisis are emphasized. The algorithm of tactics is resulted. The special emphasis is made on urgent therapy of the nephrotic crisis in children. Own supervisions of the author are resulted.

The data on the condition of central hemodynamics are resulted in cases of laparoscopic cholecystectomy at patients of high anesthesia risk. The distinctions in intraoperative hemodynamics and humoral regulation are shown in various groups of patients.

The medical examination of 302 young patients with indifferential connective dysplasia syndrome at the age of 18—23 have been carried out. Echocardiography data showed that 87.7% had atypical chordae of left ventricle, 64.2% — mitrale valve prolapse, several — papillary muscle splitting, sinus Valsalvae dilatation, bicuspid aortic valve and so on. Electrocardiography data revealed different cardiac rhythm (sinus tachycardia, sinus bradycardia, pacemaker migration, extrasystole) and conduction (bundle-branch block) disturbances. There is myocardial functional rate decreasing in half of the examined patients. It appears, therefore, that indifferential connective dysplasia syndrome should be classified as one of the most important risk factors of cardiovascular diseases.

In modern cardiology many invasive methods are successfully replaced by the non-invasive. At open heart surgeries the coronary angiography is considered obligatory at patients of advanced age. At aneurismatic aorta the coronary angiography is still a question. The retrospective analysis of 152 cases of aneurismatic aorta of the first type is done. Coronary angiography promoted increase of frequency of revealing of accompanying injuries of coronary arteries, lead to the reduction in death rate in the early postoperative period. In the long-term follow-up period patients who underwent surgery without coronary angiography needed invasive interventions concerning ischemic heart disease more often.

The case of the esophageal diaphragmatic hernia in the woman of 43 years old is described. The laparoscopic fundoplication was applied with the polypropylene mesh. It is marked, that it gives the possibility to reduce operating time, to simplify the operative techniques and to reduce the topographic anatomical changes in a zone of intervention.

Presented in the international conference "Socially Accessible Defibrillation and Prophylaxis of the sudden cardiac death" (Yuzhno-Sakhalinsk, September, 14—15, 2006). Legal aspects of introduction of programs of socially accessible defibrillation in territory of subjects of the Russian Federation are discussed on the basis of laws and acts. Practical recommendations on legal maintenance of the program at a regional level are given.

Presented in the international conference "Socially Accessible Defibrillation and Prophylaxis of the sudden cardiac death" (Yuzhno-Sakhalinsk, September, 14-15, 2006). The algorithm of introduction of the program of automatic defibrillation on industrial platforms of company ExxonMobil and its adaptation to conditions of concrete manufacture is stated.

Presented in the international conference "Socially Accessible Defibrillation and Prophylaxis of the sudden cardiac death" (Yuzhno-Sakhalinsk, September, 14-15, 2006). The features of programs of automatic external defibrillation HeartSafe are suggested by the company Medtronic Physio Control. It is concluded that introduction of similar programs in Russia will promote rendering of the duly help to the patients, that finally will lead to increase in the survival rate in people with sudden cardiac arrest.

Presented in the international conference "Socially Accessible Defibrillation and Prophylaxis of the sudden cardiac death" (Yuzhno-Sakhalinsk, September, 14-15, 2006). The successful experience of the pilot program of the automatic defibrillation in Maastricht (Holland) is shown. Recommendations on development and introduction of similar programs in other regions are given.

Presented in the international conference "Socially Accessible Defibrillation and Prophylaxis of the sudden cardiac death" (Yuzhno-Sakhalinsk, September, 14-15, 2006). The experience of the USA in the program of development of socially accessible defibrillation and the training of non-specialists to basic resuscitation is shown. As a result of the beginning of the project the survival rate of patients after sudden cardiac arrest has increased in 3 times (from 6 up to 18%).

Presented in the international conference "Socially Accessible Defibrillation and Prophylaxis of the sudden cardiac death" (Yuzhno-Sakhalinsk, September, 14-15, 2006). The review of a modern state of the combination of resuscitation and automatic defibrillation at sudden cardiac arrest. Algorithms of work of the defibrillators equipped by technology cprMAX are described. The necessity of optimization of time distribution between the stages of defibrillation and resuscitation is emphasized, and that allows increasing the efficiency of first-aid treatment.

The paper is devoted to the review of system of CPR efficiency improvement on pre-hospital stage. The obligatory basic elements are the links of chain of survival: "bystander CPR, early automatic defibrillation, advanced cardio-vascular life support on pre-hospital and hospital stages". The themes and results of international conference in Yuzhno-Sakhalinsk, September, 14—15th are described. The necessary conditions (resume of conference) for a successful beginning and developing of activity also are determined.

Experience of development of the program on application of automatic defibrillators by nonspecialists is described in case of sudden cardiac death. Social advertising has been involved, training on workplaces is done. The author marks the improvement of quality of resuscitation at two-level system: primary help is delivered by the witnesses of incident, and then experts of the first help. It is shown, that at use of the automatic external defibrillators from hospitals 40% of sudden cardiac arrest victims are discharged. In case of the automatic defibrillation in first 3 minutes after cardiac arrest the number of survivors reaches 74%.

Presented in the international conference "Socially Accessible Defibrillation and Prophylaxis of the sudden cardiac death" (Yuzhno-Sakhalinsk, September, 14-15, 2006). The activities of territorial Disaster medical center of the Perm region directed on perfection of the rescue of a life, maintenance of health and protection of the population against extreme situations are shown. The program of quality management of rendering of the first help "Service 03", consisting of: perfection of legal base, material support under united standards, perfection of system of personnel selection is suggested.

Presented in the international conference "Socially Accessible Defibrillation and Prophylaxis of the sudden cardiac death" (Yuzhno-Sakhalinsk, September, 14-15, 2006). The experience of introduction of the international project of resuscitation under ACLS standards in Yakutsk is shown. Within one year the significant success have been achieved: the time of coming of Ambulances was reduced, resuscitation activity has increased (from 39.0 up to 98.9%) and resuscitation efficiency also (from 0 up to 37.9%). It is planned to introduce the uniform protocol of the resuscitation in territory of all republic of Saha.

The main subjects of the research are the integral indicators, which may characterize effect of social-economic policy and quality of live to the public health. The author offers to use those indicators as the criteria for estimating effectiveness of the regional public health policy.

Research based on statistical information for the latest 10 years shows that quality of life remains very low due to modern social-economic policy. Also there are increasing economic losses arisen from short period of active life of the population.

The paper is devoted to the review of pre-hospital trombolitic therapy case in Vladivostok city. The trombolitic therapy (Actilyse) during cardiogenic shock and bradikardia after cardiac arrest and transcutaneous pacing was successfully made. The necessary conditions for a successful trombolitic therapy program also are determined.

The paper is devoted to the review of pre-hospital trombolitic therapy case in base camp in Sakhalin. The TLT (Actilyse) during acute myocardial infarction was successfully made in short time after the myocardial ischemia starting. The necessary conditions and indications for a successful pre-hospital thrombolisys also are determined.