Vol 44, No 1 (1963)

In modern medicine, two types of pathology rank first in their theoretical and practical significance: these are allergic (autoallergic) and tumor diseases. This leads to very significant tasks - to find rational methods of prevention, diagnosis and treatment of allergic, infectious and cancer diseases. Allergic diseases are, as a rule, the lot of internists and fewer surgeons; Although neoplasms are of interest to therapists, patients suffering from them are most often transferred to the hands of surgeons, since oncology at this stage widely uses surgical methods of treatment.

During the Second World War, the number of inpatients with essential hypertension increased by a factor of 6 in comparison with 1940; in relation to the total number of all therapeutic patients, they ranged from 30 to 50%. This so-called blockade hypertension (V.M. Chernorutsky, V.A. on its outcomes. In 1943, among all those who died in hospitals in Leningrad, 30.2% died of hypertension. In 1945, patients with hypertension accounted for about a third of all therapeutic patients (D.M.Grottel, 1946) and 23.3 - from those who died in hospitals (S.S. Weil, 1956).

When prescribing sanatorium-resort treatment for patients with diseases of the circulatory system, the possibility of maintaining their usual climatic conditions instead of the necessary adaptation to other conditions when traveling to remote resorts, especially to the southern regions of the country, is of great positive importance. In order to check this provision in practice, we decided to analyze the results of treatment of cardiac patients in the sanatoriums of the Kuibyshev region "Sergievskie Mineralnye Vody", "Krasnaya Glinka" and V. Chkalov, where the contingent of residents of the Kuibyshevskaya and adjacent regions with approximately the same climatic conditions, characteristic for the middle zone of the Soviet Union (Middle Volga region).

According to Kogan-Yasny and Genes, the content of lactic acid in the blood during hypertension rises to 25-45 mg%. Gefter in all cases of hypertension found an increased content of lactic acid in 41.6% of cases in the range of 13-25%, in 5.6% more than 25 mg% and in some cases up to 60 mg%. Idelchik, during the blockade of Leningrad, established an increased content of lactic acid in the blood both in hypertensive patients (78 out of 92) with manifestations of sclerosis and without them. A persistent increase in lactic acid in the blood was observed in severe forms of hypertension complicated by circulatory failure. Rodov and Anguladze also observed an increase in lactic acid in hypertension and attributed this phenomenon to circulatory disorders and insufficient oxygen supply to tissues. Perchik investigated lactic acid in 46 patients with various forms of hypertension and in all cases found increased numbers, the lowest - with neurocirculatory, "autonomic nervous hypertension", the highest - with hypertension with heart failure.

Changes in the exchange of electrolytes - sodium, potassium, chlorine - in hypertension, established by a number of authors, have recently been associated with the influence of mineralocorticoids, mainly aldosterone. The participation of adrenal cortex hormones in the pathogenesis of hypertension was noted by many (A.L. Myasnikov, Selye, Cyres, Perera, etc.). Grolman and co-workers, Selye, Sapeika, with long-term administration of deoxycorticosterone, obtained persistent hypertension in experimental animals. Persistent aldosterone hypertension obtained by Kumar and co-workers.

In the complex of medicinal prescriptions in the treatment of patients with circulatory disorders, diuretics occupy a special place. We can confidently say that with a pronounced edematous state, no cardiac drugs, including glucosides, can lead to a stable release of the patient from the fluid retained in the body. The latter is achieved only by the appointment of diuretics.

There are a large number of methods for imposing anastomosis on the gastrointestinal tract. In particular, the so-called closed and aseptic methods of gastroenterostomy and interintestinal anastomosis are described. It would seem that the widespread use of antibiotics in clinical practice should exclude the occurrence of peritonitis in the postoperative period, and the formation of anastomoses by the open or closed method is not essential. But it is known that antibiotic-resistant microorganisms have appeared, and peritonitis after operations on the gastrointestinal tract, especially on the large intestine, as well as in cancer patients, continues to be the main cause of postoperative mortality (H. N. Petrov, 1956; I. Ya. Deineka, 1960). This is confirmed by reports from other authors. The mortality rate from peritonitis after large intestine surgeries is especially high - from 37% to 74%. Peritonitis is also observed after gastroenterostomy, especially in patients with cancerous lesions of the stomach (KL Berezov, 1960). According to N.I. Krakovsky (1960), in hospitals of the RSFSR, postoperative mortality from gastroenterostomies in gastric ulcers was 7%, and in gastric cancer — 13%.

Urolithiasis in the USSR is more common in the south of our country: in Armenia, Azerbaijan, Georgia, Dagestan, Central Asia, Donbass, etc. (N.Z.Minchin, G. B. Teplitsky, N. A. Yakovlev and etc.). The Volga region also belongs to the areas where urolithiasis occurs quite often.

Kidney stones in children, as is commonly thought, are very rare. This can be confirmed by the fact that the works of Soviet surgeons contain a description of an extremely small number of nephrolithiasis in children.

We have studied the course of labor in 33 patients with late toxicosis. In 92 patients (26.5%), childbirth was premature. The overall percentage of premature births in this institution during this time was 6.5.

The development of climacteric syndrome is considered as a result of not only hormonal disorders in the woman's body, but also disorders of the central nervous system associated with them, and in particular the hypothalamic region (Quater, Crimean, Solovyova and Ugoleva, etc.). In this regard, in the treatment of climacteric syndrome, not only hormonal therapy occupies a significant place, but also general strengthening agents that tone and normalize the state of the central nervous system, eliminating disorders of the vascular system, metabolism and improving muscle nutrition.

Antabuse, like its analogue, thiuran, is tetraethylurandisulfide. The toxic reaction during its use can be of different severity: from mild, tolerated by patients without therapeutic intervention, to severe toxicosis with a sharp suppression of cardiovascular activity, with toxic psychoses. The most important property that caused its use as a therapeutic drug is the incompatibility of antabuse with alcohol while taking them. It has been established that antabuse delays the oxidative process of alcohol and leads to the accumulation in the body of its decay products, toxic to most organs and systems.

Treatment of burn disease takes an important place in the work of a surgeon in a district hospital.

In the domestic literature, descriptions of large hydronephrosis have been published to date. So, S.I.Rabinovich (1954) reports about a patient of four years old who underwent extraperitoneal removal of a hydronephrotic kidney measuring 29 X 23 X 11 cm and weighing 5 270 g.

L., 26 years old, 16/VIII-60 at 16 o'clock. taken from the local hospital with a diagnosis of acute abdomen.

14/VІІІ at 18 o'clock suddenly there were pains in the abdomen, was treated at home with a heating pad. 15/VІІІ turned to a paramedic for help. After taking the pills, the pain subsided, but by the evening the condition worsened, the abdominal pain intensified. She was admitted to the Khodar district hospital at 16/VIII at 12 o'clock, from where she was directed to the district hospital.

In recent years, a peculiar disease has attracted attention, the main and sometimes the only symptom of which is an increase in the total number of mature peripheral blood lymphocytes. The duration of the disease is from a week to a month. The disease usually ends with recovery. It is believed to be caused by an unknown virus. Epidemic outbreaks of acute infectious lymphocytosis (o.i. l.) Are described, and its high contagiousness was also noted. According to Wintrobe (1946), there were 56 reports of acute infectious lymphocytosis in the world literature. In subsequent years, the number of works increased.

With the help of electrocardiography, we can judge the three most important functions of the heart: automatism, conduction and excitability. The method of ballistocardiography makes it possible to judge the function of contractility.

The operation of ligation of the internal thoracic artery (Fieski) is simple to perform, does not require special instruments and anesthesia. From complications during the operation, damage to the pleura and injury to the internal thoracic artery are possible. Careful carrying out of the operation guarantees against complications. Our material covers 26 patients. There were 22 men, 4 women. Up to 40 years there was 1 patient; up to 50 years - 13; up to 60 years old - 9, over - 3.

12 men and 6 women (from 30 to 62 years old) who died from hypertension confirmed in the section were examined. The duration of the disease (by history) is from 4 to 20 years. In all cases, high blood pressure figures were noted - 220-140 (maximum) and 139-90 (minimum). The immediate cause of death in 10 patients was heart failure, in 5 - cerebral hemorrhage and in 3 - uremia.

The study of the interictal period of rheumatism is very important, since with the end of the acute attack of rheumatism, the disease does not stop, but continues to progress, changing only the rate of its course.

We set out to investigate: what is the secretion of the stomach, when a lot of fluid from the outside enters the body and when the tissues and blood are somehow overloaded with fluid. Using the cuprosulfate method, we showed (16 cases) that after resection of the pylorus, with a water load of 600 ml, when water quickly passes into the small intestine and is absorbed, the specific gravity of blood and plasma decreases, blood protein decreases, hemoglobin and hematocrit fall ( hydremia).

Observations of the incidence of angina among the railway workers of the Belorechensky junction S.K.zh.d. and their families were started in 1949 and were carried out through 1958 inclusive. Our material covers 2194 patients with angina.

In the Soviet and foreign literature, much attention is paid to the issue of the emergence of antibiotic-resistant strains of microorganisms, which increases the number of complications.

In cases of infectious metro-endometritis, instead of extremely traumatic and dangerous curettage, we used intrauterine administration of a 5% ethereal citral solution. In this case, the combined action of citral and ether is used. In the ether vapors formed at body temperature in the uterine cavity, citral (volatile phytoncide) is able to more fully and sooner affect the uterine microflora. With this technique, very often we managed to avoid instrumental revision of the uterine cavity even with organized placental polyps. In those cases where time was lost and there was too strong a connection between the polyp and the uterine wall, after the preliminary introduction of citral, we were able to perform curettage under conditions of significantly less infection of the uterus.

We observed two brothers 4 and 6 years old, poisoned by Granozan. The mother of these children worked in the collective farm garden in the summer of 1960, and the children were constantly with her. To combat pests, vegetables were sprinkled with granosan; in the same garden there were ridges planted with berries that the children ate.

We present observations on 50 patients with neuritis of the auditory nerves, treated from 1951 to 1960 by daily administration of oxygen under the skin in the area of the mastoid processes. The first injection was 10 ml, then the dose was increased daily by 5 ml. The dose was brought to 100 ml. The treatment lasted 20 days. In some patients, according to indications, the treatment was repeated after 1-2 months. More than 3 courses a year were not carried out.

During the years of Soviet power, the state of health of the population of our country has undergone radical changes for the better. Dangerous infectious diseases - cholera, plague, smallpox, parasitic typhus - have been eliminated. Malaria, which was especially widespread in the Volga region, also disappeared.

In the course of many years (45 years) of medical practice, I have to remember my Alma mater many times.

During the operation, difficulties in recognizing pathological changes in the stomach are often encountered. Detection of initial gastric cancer is an unresolved diagnostic problem in laparotomy. Histological studies have shown that the definition of the boundaries of cancerous infiltration of the wall of the stomach or esophagus is often erroneous. Difficulties are encountered in the differential diagnosis between some forms of cancer and peptic ulcer. An ulcer or erosion that served as a source of bleeding may not be detected during laparotomy. Relapses of gastric polyposis, cancer of the stump after resection for cancer or polyps are most often the result of an incorrect assessment of the state of the wall of the preserved part of the stomach.

The congress discussed the problems of nervous and mental diseases of infectious origin in adults and children, as well as geriatrics and medical examination of the elderly. 608 delegates attended (350 psychiatrists, 246 neuropathologists, 12 physiologists and pathologists).

Many women die from the wrong actions of doctors in the provision of emergency obstetric and gynecological care. The reasons for this lie in ignorance of prophylaxis, incorrect or late diagnosis and, especially, incorrect medical tactics. Any measure that helps the doctor learn how to properly provide emergency obstetric and gynecological care is commendable. One such measure is the publication of good textbooks on the subject. These textbooks include peer-reviewed collective leadership. The special value of the latter is that it is designed for rural district and local doctors.

The book under review is conceived as a short guide to the methodology and technique of neurological research and is designed primarily for a general practitioner who is faced with the need to establish the presence of damage to the nervous system and the patient's need for referral to specialized research and treatment.

On August 10, 1962, the associate professor of the Department of Otolaryngology of the Kazan State Pedagogical University named after V.I. V.I. Lenin, candidate of medical sciences Grigory Arturovich Zharkovsky.