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The features of clinical and laboratory diagnostics of hantavirus infection at the prehospital stage in the regions of the Northwestern Federal District is considered. The analysis of the terms of patients treatment from the moment of the appearance of the first symptoms of the disease was carried out. It was found that more than half of the patients sought a medical help during the height of the disease. The structure of hospitalizations of the patients with a hemorrhagic fever with renal syndrome who were admitted to inpatient treatment was studied; most patients were hospitalized by the ambulance team. The data of our own research are presented, indicating the predominance of the nonspecific symptoms in the onset of the disease. The overwhelming majority of the patients in the initial period of the disease had fever, severe headache, myalgia. Hemorrhagic syndrome was detected in a minimal number of the patients. The dynamics of the clinical picture of a hemorrhagic fever with the renal syndrome in patients admitted to hospitals in St. Petersburg was analyzed. Diversity and a rapid change of the symptoms and syndromes in dynamics were noted. In the structure of diagnoses of the direction, diseases of the respiratory system prevailed. A smaller proportion of a preliminary diagnoses were diseases of the gastrointestinal tract, pathology of the kidneys and urinary tract, diseases of the central nervous system, and only one patient was diagnosed with the hemorrhagic fever with renal syndrome. The laboratory parameters of the early period of the disease in patients were assessed. The most frequent and characteristic changes in the blood and urine parameters were revealed. Signs of hemoconcentration and thrombocytopenia were noted in almost half of the patients in the initial period of the disease. In a small part of outpatients, impaired renal nitrogen excretory function was found; the intensity of azotemia in the initial period of the diseases was low. Urine changes in the initial period were characterized by the moderate proteinuria, leukocyturia, erythrocyturia, cylindruria. The need for a thorough comparison of a clinical, laboratory, epidemiological data for a timely and correct diagnosis is noted.

In case of antitumour anthracyclines therapy of patients with non-Hodgkin lymphomas the possibility of using speckle-tracking echocardiography is being considered. It was found that patients with non-Hodgkin lymphomas have early violations of the left ventricular myocardium during the course of antitumor chemotherapy using anthracyclines. They are characterized by reducing of longitudinal deformation of the myocardium with a gradual spread from the apical to the basal segments of the left ventricle. A statistically significant reduction in global and segmental systolic deformation after the 4th course of chemotherapy (cumulative dose of doxorubicin 333.5 88.5 mg/m2) is the earliest marker of left ventricular mechanical dysfunction, appearing before the development of diastolic dysfunction and ejection fraction reduction of the left ventricular. Early violations of myocardial mechanics in the dynamics of the course of antitumour therapy with anthracyclines are identified in the apical area of the left ventricle, it can be connected with circulatory failure in this area. Violations of myocardial mechanics in the apical area of the left ventricle can be an erly predictor of ischemia of this area with possible progression to global contractile muscle dysfunction of the left ventricular. The global longitudinall deformation of the left ventricular myocardium in contrast to ejection fraction of the left ventricular is more sensitive to myocardial damages against the backdrop of chemotherapy using anthracyclines. So, it can be used as an early preclinical marker of myocardial damage, that takes echocardiography closer to the most advanced methods of myocardial visualization.