Institute of Hematology on the 2nd Soviet official. Russian Medical Academy of Continuing Professional Education

23.04.19 14:19:29

On January 16, 2018, Gusakova Larisa Georgievna, age 58 years old (11/26/1958), was admitted to this institute for treatment from Pskov with a diagnosis of Multiple myeloma with secretion of immunoglobulin G, because she endured the road to St. Petersburg quite well and her condition upon admission was quite bearable (satisfactory ). Garifulin Andrey Damirovich was appointed as the attending physician. On January 21, the patient's condition deteriorated sharply and Larisa called me (at the request of the doctor) to take care of her, since there are no nurses for the seriously ill at the research institute. The next day I arrived. The meeting with Andrey Damirovich and further communication made a very good impression. Attentive, told in detail what caused such a sharp deterioration in the condition and what measures are being taken to stabilize. It turned out that Larisa had pneumonia and heart failure on its background. According to the underlying disease, treatment is contraindicated until the pneumonia is cured. Since Larisa was forbidden to get up and she needed constant care, Andrei Damirovich resolved the issue and placed me in the same room. Unfortunately, the doctor himself fell ill two days later and was replaced by Elena Viktorovna. Also the same attentive and caring. Thanks to her decisive actions, the patient's condition improved markedly and repeated x-rays (according to the doctor) showed this. The drawing of the lungs began to be seen and the heart decreased in size. This was said on Friday January 26th during the round. Naturally, both for the patient and for me, this was encouraging news. And suddenly at 17:00 the doctor on duty, who introduced himself as Ivan Ivanovich, comes into the ward and declares that the pneumonia is viral (the answer to the tests taken earlier has just come) and the head physician decided to send the patient to the infectious diseases hospital named after I. Botkin, and at 18:00 an ambulance will arrive for transportation. This was overwhelming news and we were unable to comprehend it immediately. But when Ivan Ivanovich came again, I announced that I wanted to meet with the head physician, to which I received the answer that he was no longer there. In that case, the wife will stay here until Monday. And it began! Allegedly, the patient may start bleeding at any moment, but they do not have resuscitation and I endanger her life. And other patients are in danger, and I don't understand anything, and so on and so forth. And he took me out into the corridor for a conversation, and assured me that as soon as the pneumonia was cured, it would be taken back to the research institute to continue treatment for the underlying disease. "But after all, the attending physician announced an improvement literally three hours ago, and if the patient has been lying with this virus for more than a week, which makes it difficult to stay for two more days." If I had not been a common-law husband, Larisa would have been taken away only through my corpse, and if the conflict escalated and it became clear that de jure I was no one for Larisa, it would have been no problem to expel me. And I told Larisa that I leave the decision to her. Unfortunately, she agreed. So, in "Botkin" I was told that no virus was found during the second analysis. And when pneumonia was cured, the research institute categorically refused to take it. In addition, according to their discharge, she was not taken to any hospitals, no matter how hard the head tried to do it. intensive care unit. And it became clear to me that in this way they simply got rid of the patient L.G. Gusakova. In Botkin, the main disease began to progress rapidly and on February 17, 2018, Larisa passed away. I cannot give an assessment of the research institute for professional activity. I will only note that in the wards the patients do not even have buttons for calling the medical staff and this, I will note, in the leading research institute, and the state of the wards themselves leaves much to be desired. Much time has passed, but the wound from the departure of the wife and mother of our son still hurts and bleeds. And I am writing because I want to ask Ivan Ivanovich: "Aren't you ashamed of your deception and lies, sleep well at night?" And was the head physician really involved in this deception? It is shameful and painful that there are such soulless "doctors". Without respect, Goromulinsky Gennady Alexandrovich. 8 900 99 * ** **. Let the readers give the assessment!

In October 1931, the country's first blood transfusion station was opened in Leningrad. One of the initiators of the opening of the station, the surgeon E.R. Hesse, soon proposed to reorganize it into an institute. In 1932, the Leningrad Research Institute of Blood Transfusion was opened.

At present, the Research Institute of Hematology and Transfusiology (as it has been called since 1993) has become the leading scientific center of the hematological and transfusiological service in Russia. It is the head institution of the Ministry of Health of the Russian Federation - in fact, it oversees the entire blood service of the country and acts as a scientific and methodological center. This is a rare case when the main medical institution is not located in Moscow.

The main directions of the Institute's clinical activities are the treatment of oncological diseases of the blood and diseases associated with impaired blood coagulation processes. The institute is all-Russian and provides medical care to patients from all regions of the country. In St. Petersburg, patients from 9 districts are assigned to him (patients in the other districts are treated at the MAAP and St. Petersburg Medical University named after I.P. Pavlov). Annually, up to 40,000 outpatients are consulted in the polyclinic department of the institute, and another 1000-1200 patients are treated in a hospital.

The Institute has two clinics with 76 beds. The surgical clinic specializes mainly in the treatment of patients with hemophilia. The Hematology Clinic deals with the treatment of diseases of the blood system (leukemia and aplastic anemia). In 1991, a small 6-bed bone marrow transplant department was opened.

Hospitalization procedure

Hospitalization in the clinics of the Research Institute of Hematology and Transfusiology is carried out after consultation in the outpatient department of the Institute. For residents of St. Petersburg, when applying, a referral from the polyclinic at the place of residence is required. For residents of other regions of the Russian Federation - a referral from the regional health committee. Most of the medical services are provided within the framework of

The Moscow City Hematology Center (MGHC) was established in 1971 on the basis of the Botkin Hospital. The main directions of his work are the provision of advisory and medical assistance to patients with diseases of the blood system and the implementation of organizational measures to improve the hematological service in the city of Moscow.

MGHC provides outpatient and inpatient care for 45% of hematological and oncohematological patients - residents of the city of Moscow.

Today it is located in the newly renovated building 17 of the GKB im. S.P. Botkin, equipped with all the necessary medical equipment. Patients have access to modern methods of diagnostic examination, necessary for the diagnosis and monitoring of the therapy. This allows in a semi-ambulatory mode to conduct courses of chemotherapy, immunity, targeted therapy that meet world-class standards, as well as replacement transfusions of blood components.

The center's capacities are high: every day more than 250 patients are provided with outpatient care, including those who have applied for the first time (30-45 patients per day), every day 100-120 patients receive therapy courses in a day hospital, which made it possible to significantly relieve hematological 24-hour hospitals and create conditions for carrying out therapy on an outpatient basis. The possibilities of the MGHC continue to expand, the diagnostic base and the staff are strengthened. Today, MGHC has 40 employees, most of whom have the highest qualification category. Of the 14 doctors working in the center, 2 are doctors of medical sciences and 5 are candidates of medical sciences.

Head of the Department

Doctor of Medical Sciences

Nikitin Evgeny Alexandrovich

Head of the educational department

Candidate of Medical Sciences, Associate Professor

Rimashevskaya Elena Vladimirovna

125167, Moscow, Novy Zykovsky pr., 4
129128, Moscow, st. Budayskaya, 2
(Central Design Bureau named after N.A.Semashko, JSC "Russian Railways")

The department was created in 1934, its first name was "III Department of Therapy" and the first head was an outstanding therapist, cardiologist D.D. Pletnev, who died during the years of Stalinist repressions.

After him, the department was headed by M.B. Kogan, and from 1938 to 1971. the department was headed by Academician of the USSR Academy of Medical Sciences I.A. Kassirsky is a genius doctor, scientist-researcher, teacher, teacher of many domestic therapists and hematologists, a worthy successor of A.A. Maksimova, A.N. Kryukov.

It was I.A. Kassirsky is credited with creating a unique team of the department, where they taught not only hematology, but also therapy, cardiology, intensive care and transfusiology.

In 1965, the III Department of Therapy was renamed the Department of Hematology, Intensive Care with a course of rheumatology. Then the course of rheumatology was separated into a separate department.

From 1971 to the present, the department is headed by Academician A.I. Vorobiev.

In 1997, the department was renamed the Department of Hematology and Transfusiology.

Every year at the department up to 260 doctors and teachers improve their qualifications on topical issues of hematology, industrial and clinical transfusiology. Among the trainees there are 36 doctors of sciences and 79 candidates of sciences.

Lectures, practical and seminars, as well as morning clinical conferences, morphological analyzes and clinical and anatomical conferences are held with the involvement of the country's leading specialists in clinical hematology and transfusiology. This form of training attracts medical practitioners from clinical hospitals in Moscow. In the course of training, videos are increasingly used on the most pressing issues of the practical activities of hematologists and transfusiologists, video lectures are held for doctors who are outside Moscow at their workplaces.

The main goal of all training cycles is to prepare doctors for independent work in the field of hematology and transfusiology; to acquaint doctors of other specialties with the basics of hematology, differential diagnostics; to teach the pathogenetic approach to substitution therapy, prevention of post-transfusion complications.

This includes mastering the methods of sternal puncture, trepanobiopsy, knowledge of the morphology of blood cells, the ability to determine group and Rh affiliation, knowledge of modern methods of diagnostics and treatment of hematological patients, knowledge of clinical transfusionology, knowledge of all methods used in industrial transfusion. the curriculum is occupied by the section of orphan diseases, their diagnosis and therapy.

Lectures are given and seminars and practical classes are held in the diagnostic sections of the program: histology, immunohistochemistry, karyology, immunochemistry.

The main research topic, on which the staff of the department have been working in recent years, is the development of new programs for the therapy of tumors of the lymphatic system, the study of the molecular foundations of the genesis of lymphoproliferative diseases and the improvement of the diagnosis of lymphomas.
Within the framework of this topic, work is carried out in the following areas:

• Investigation of the mechanisms of oncogenesis leading to malignant transformation of lymphocytes. The work is carried out jointly with the Department of Hematology of the La Sapienza Institute, Italy, Rome.
• Development of new methods for molecular and immunological diagnostics of lymphatic tumors. The work is carried out on the basis of the laboratories of molecular hematology, karyology and immunochemistry of the Federal State Budgetary Institution State Research Center of the Ministry of Health of the Russian Federation, as well as the immunophenotyping laboratory of the Department of Clinical Clinical and Laboratory Diagnostics of the Russian Medical Academy of Postgraduate Education.
• Development and implementation into medical practice of new programs for the treatment of tumors of the lymphatic system. It is carried out on the basis of clinical divisions of the Federal State Budgetary Institution State Research Center of the Ministry of Health of the Russian Federation (departments of hematology and intensive care, hemodialysis, resuscitation and intensive care). Together with the Moscow Hematology Service, the department conducts multicenter clinical trials of new therapy regimens.
• Development of optimal tactics for the management of lymphatic tumors in elderly and somatically burdened patients: treatment of lymphomas in patients with renal failure, hepatitis, heart failure and cardiotoxic complications, thrombophilia and thrombotic complications. The topic is supervised by the staff of the department on the basis of clinical departments of the Federal State Budgetary Institution State Research Center of the Ministry of Health of the Russian Federation.

Another, no less important, research topic on which the Department of Hematology and Transfusiology is working is the study of the problems of modern industrial and clinical transfusiology. The work is carried out in the following directions:

• Development and implementation into practice of the fundamentals of the country's blood service within the framework of the unified information space of transfusiology being created. Approbation of new modern technologies for recruiting donors.
• Investigation of the possibility of creating a unified information "road" map of the movement of a blood component "from the donor vein to the recipient's vein" in order to study the effectiveness of transfusions and reliably record possible complications of transfusion therapy.
• Study and creation of transfusion therapy protocols for specific clinical situations (sepsis, cardiogenic shock, hemorrhagic shock) based on a new understanding of the pathogenesis of their development and correction.

The staff of the department took an active part in the preparation of the new edition of the Federal Law "On the donation of blood and its components", which entered into force on January 20, 2013. I.A. Cashier's traditional April decade "New in Hematology, Transfusiology and Radiation Therapy" is attended by hematologists, transfusiologists and blood service doctors from all over the country (in different years, on average, at least 80-125 listeners).
Traditionally, the staff of the department participates in domestic and foreign conferences, congresses, symposia, speaking both with plenary reports and with poster presentations.

Over the past 5 years, the following have been published:

• "Guide to Hematology" (3rd edition) (2008)
• Intensive Care Manual (2009)
• "Guide to Surgery" (2008)
• "Guide to Parenteral Nutrition" (2013)
• "Intensive Care", short edition (2012)
• "Guide to Geriatrics" (2012)
• several monographs in which the staff of the department are the authors or co-authors of many chapters and sections.

The activities of the Department of Hematology and Transfusiology are a vivid example of the continuation of the well-known hematological school of A.N. Kryukov, which is based on the obligatory morphological diagnosis of tumor diseases of the blood system by a clinician together with a specialist pathologist.
Joint interpretation of the obtained morphological, clinical and laboratory data is the most important section of the department's work. The experience of such work is constantly passed on to all students at the department.

For the educational process, there are 2 conference rooms equipped with modern equipment for clinical demonstrations and lectures, there are modern microscopes for morphological studies and other office equipment.

vana for approval The program of the entrance exam for postgraduate studies in the specialties "Hematology" and "Transfusiology".

In the educational process, traditional (lectures, seminars, practical exercises) and innovative forms of pedagogy are used, videos of lectures by academician A.I. Vorobyov on the main sections of hematology and transfusiology.

1. Abramov M.G. - Hematological atlas. - M., 1985.
2. Alekseev N.A. - Anemia - Hippocrates -2004.
3. Anderson S.K., Poulsen K.B. - Atlas of Hematology -Logosphere - 2007.
4. Andreeva N.E., Chernokhvostova E.V. - Immunoglobulinopathies - M., 1985.
5. Andreeva N.E. - Diagnostics and treatment of multiple myeloma - M., 2001.
6. Vorobiev A.I., Gorodetsky V.M. - Acute massive blood loss-GEOTAR-MED, 2001.
7. Therapist's Handbook / Ed. Vorobieva A.I. - M., 2000.
8. Clinical hematology oncology / Edited by M.A. Volkova - M., 2010.
9. Guide to Hematology / Edited by A.I. Vorobiev. - M, 2005, in 3 volumes.
10. Atlas - Tumors of the lymphatic system / Edited by A.I. Vorobiev - Nyudiamed. 2007.
11. Andreev YN - Many-sided hemophilia -. - Newdiamed. 2006.
12. Essays on industrial and clinical transfusiology / Ed. Vorobieva A.I. 2001.
13. Rational pharmacotherapy of diseases of the blood system / Ed. Vorobieva A.I. - Literature -2009.
14. Gorodetsky V.M. - Infusion - transfusion therapy in clinical medicine - MIA, 2009.
15. Gorodetsky V.M. - Intensive therapy - GEOTAR-Media, 2009.
16. Dolgov V.V., Svirin P.V. –Laboratory diagnostics of hemostasis disorders - Triad 2005.
17. Donskov S.I., Yagodinsky V.N. - Heritage and followers of A.A. Bogdanov in the blood service, M. 2008.
18. Egorova M.O. - Biochemical examination in clinical practice - Practical medicine, 2008.
19. Kaufman G.A., Mandell D.L. - Atlas of fungal diseases - GEOTAR-Media, 2010.
20. Lugovskaya S.A., Morozova V.T. –Laboratory diagnostics of anemias –M “Provincial medicine”, 2001.
21. Lugovskaya S.A., Postman M.E. –Hematological atlas - Triad-2004.
22. Mineeva N.V. - Human Blood Groups. Fundamentals of Immunohematology - State Research Institute
23. transfusiology and hematology, St. Petersburg, 2004.
24. Rumyantsev A.G., Maschan A.A. et al. - Concomitant therapy and control of infections in hematological and oncological diseases - Medpraktika - M, 2006.
25. Rumyantsev A.G., Samochatova E.V. - Pediatric hematology and oncology -
26. Medpraktika - M, 2004
27. Medical mycology / Ed. Sboychakova V.B. - GEOTAR-Media, 2008.
28. Programmed treatment of leukemia / Ed. Savchenko V.G., State Scientific Center - 2008.
29. Smirnov A.N. - Diseases of the blood - Encyclopedia, 2005.

The department is based in 2 treatment-and-prophylactic institutions: the Hematological Research Center and the N.A. Semashko JSC "Russian Railways", equipped with the most modern equipment, allowing for the diagnosis and treatment of hematological and orphan diseases.

About 500 patients undergo treatment annually. The staff of the department also provide advice in various medical institutions in Moscow and in other regions of the country. The number of consultations per year is 300. Address and directions:
Hematological Research Center - Novy Zykovsky pr., 4
Directions - m "Dynamo", bus. No. 105 to the stop. "1st St., 8th March" or march. taxi number 4 to the stop. "Hematological Research Center",

TsKB im. ON THE. Semashko JSC "Russian Railways" - st. Budayskaya, 2
Directions - m "VDNKh", bus. No. 56 to the end.