Vol 64, No 5 (1983)

First of all, I would like to express my deep gratitude to the Rector's office and the academic council of the Institute for giving me the honor to make an assembly speech on such a solemn day.

Acute occlusion of the terminal abdominal aorta and its main branches (renal, mesenteric and iliac arteries) is one of the most severe and difficult to surgically treat types of emergency vascular pathology. According to sectional data, it is detected in 0.15-2% by autopsy [18, 19] or in 8-9 patients out of 10 thousand admitted to hospitals of all profiles [18]. In recent decades, these indicators have tended to increase continuously [5, 6, 9, 13]. Mortality reaches 80% in acute thrombosis of the aorta and mesenteric arteries [2, 8, 11]. In these cases, anticoagulant therapy without restoring blood flow is usually ineffective [2, 4, 5, 10].

The problem of treating patients with ulcerative form of postthrombophlebitic syndrome (PTFS) of the lower extremities is one of the most difficult and urgent in angiosurgery. This problem is turning from a medical problem into a social one, since huge funds are spent on the treatment of patients with PTFS in all countries of the world.

The search for optimal diagnostic and prognostic criteria for acute myocardial infarction is one of the urgent tasks of emergency cardiology. Of particular interest in this regard may be the analysis of changes in the blood levels of various collagen metabolites, since the necrotic focus that occurs in the acute period of infarction affects not only muscle tissue, but also the connective tissue backbone of the heart.

In recent years, artificial short-term hyperthermia of the body (KG) has been widely used in a complex of therapeutic and preventive measures against diseases of the circulatory system, including myocardial infarction [7], in the treatment of malignant tumors [3] and as a non-specific means of sports training [6]. However, there have been reports of cases of acute coronary insufficiency and sudden death due to KG [13], the possibility of occupational diseases of the cardiovascular system in individuals whose work is associated with hyperthermic loads [10], require a detailed assessment of the functional state of the heart and criteria pathognomonic for detecting early preclinical stages of heart failure with artificial hyperthermia. The literature data on this problem are contradictory and few. Identified by a number of authors, some disorders of cardiac activity in KG were not considered signs of functional inferiority of the myocardium, and their diagnostic value was not considered [11]. However, at present there are not sufficient grounds for rejecting the established ideas about the clinical significance of cardiac disorders under various exogenous influences, especially when solving problems related to the professional and therapeutic and preventive aspects of artificial hyperthermia.

Currently, hemodialysis is one of the effective methods of treatment of end-stage chronic renal failure (CRF). As is known, with this method of purification, the patient's blood comes into direct contact with a semipermeable membrane over a large area, through which nitrogenous slags are removed from the body. Despite the fact that in order to prevent blood clotting in the extracorporeal system, its heparinization is carried out, sometimes there is thrombosis of the dialyzer and its highways. A similar complication was observed by M. D. Javad-Zade and P. S. Malkov (1978) in 1% of cases, and I. S. Yarmolinsky and X. K. Chernevskis (1978) - in 2.5%. In this regard, all new membranes created for hemodialysis need to be studied by their interaction with blood.

The change in the functional state of the endocrine glands in diabetes mellitus and its complications attracts the attention of researchers. The data of individual studies devoted to the effect of diabetes on the functional state of the testicles, the production and metabolism of testosterone are very contradictory. Some authors report on the normal androgenic function of the testicles in diabetes, including the development of impotence in patients (10, 11, 14). Others note changes in the level of testosterone and its metabolic products [1, 2, 7, 8].

Vascular disorders occupy a significant place in the clinical picture of chronic alcoholism and alcoholic psychoses. Electrophysiological research methods (electro-, peo-echoencephalography) make it possible to objectify brain changes [1-3]. However, the issue of violation of cerebral hemodynamics and the state of the ventricular system of the brain in patients with chronic alcoholic psychoses remains unclear.

It can be assumed that the development of pathological processes of the uterus and appendages is largely associated with changes in blood circulation. This could be confirmed by the results of a comparison of blood pressure in the vessels of the affected and intact appendages. In this regard, we performed angiotensometry of the ovarian artery and the tubal branch of the uterine artery. To measure blood pressure, an apparatus proposed by M. 3. Segal and A. I. Lisin was used (author's report No. 360075 of_5/IX 1972). The research methodology did not differ from the one described earlier. Taking into account the features of the object of observation, we reduced the size of the rigid camera and changed its shape, mounted a fluoroplast light diffuser in it, redesigned the branch of the apparatus. Blood pressure was determined during operations in the ovarian artery, as well as in the vessel adjacent to the fallopian tube at 2 points — at the level of its isthmic and ampullary parts.

One of the clinical manifestations of atherosclerosis is dizziness, which a number of authors explain by the localization of otosclerotic foci in the capsule of the vestibular part of the labyrinth. These foci can have a mechanical effect on the contents of the labyrinth, obstruct the circulation of fluid in the inner ear due to compression of the perilymphatic space and thereby cause the occurrence of vestibular disorders.

Taking into account the available literature data on general anesthesia in pediatric ophthalmic surgery, in our clinical practice we use the most suitable method of oropharyngeal anesthesia for all age groups [3, 5]. But unlike the generally accepted method, we seal the system with an inflatable cuff of our design, and also perform anesthesia with an azeotropic mixture.

Diagnosis and treatment of acute diseases of the extrahepatic biliary tract sometimes present significant difficulties, especially in elderly and senile people. This problem is also complicated by the fact that sometimes with inflammation of the gallbladder that does not respond to conservative therapy, it is difficult to decide on an emergency operation, especially in elderly and senile people with severe concomitant diseases, since their operational risk is too high. Surgical intervention is also extremely dangerous for patients with long-term mechanical jaundice, since in the postoperative period they may have progression of existing liver failure. In such cases, laparoscopic cholecystostomy is justified as a therapeutic method [2]. According to the method proposed by I. D. Prudkov (1974), it is necessary to remove the bottom of the gallbladder and attach it to the skin of the abdominal wall. However, with a sharply infiltrated and edematous wall of the gallbladder, as well as with its dense fusion with the edge of the liver, it is not possible to remove its bottom and fix it to the skin of the abdominal wall. All this significantly limits the possibilities of laparoscopic cholecystostomy using this technique. In such cases, transhepatic cholecystostomy is indicated [1, 3].

4591 electrocardiograms of patients treated during the year in eleven departments of a multidisciplinary hospital were analyzed. Various types of intraventricular blockages were found in 99 (2.2%) patients. Among them there were 36% women, .64% men. 87% of patients were over 46 years old. 40.4% of patients with intraventricular blockages were treated in the cardiology department, 14% — in gastroenterology, 12% -in neurology, the rest - in surgical, gynecological and endocrinological departments.

Errors in the diagnosis and removal of foreign bodies of the esophagus often lead to severe, life-threatening complications for the patient. In case of non-penetrating esophageal injuries complicated by abscess (phlegmon) of the esophageal tissue, and with penetrating injuries of the cervical and thoracic to the level of the Th V of the esophagus, regardless of the age and condition of the patient, it is necessary to perform a transversal mediastinotomy with active drainage.

Comparative evaluation of various types of vagotomy, diagnosis and prevention of complications such as ischemic necrosis, damage to the Latarge nerve, should include an assessment of hemodynamic and motor parameters of the gastrointestinal tract. To do this, we used an apparatus including a rigid pressure chamber with a rubber membrane and a light source with an opposite transparent plate (M. 3. Segal, Pat. physiol., 1981, No. 3).

In recent years, there have been reports of the development of thrombohemorrhagic syndrome in patients with salmonellosis. We also observed 7 patients with salmonellosis who had clinically pronounced thrombohemorrhagic syndrome. The course of the disease in one of them was complicated by massive bleeding into the parenchyma of the lungs, in the other by hemorrhage into the brain substance. In 2 patients, thrombosis of mesenteric vessels was detected, in 3 — multiple hemorrhages in the mucous membranes of the small intestine and in 3 — colon. Thrombohemorrhagic syndrome developed against the background of toxic and infectious shock, which led to fatal outcomes. It is known that with salmonella intoxication in the patient's body, not only hemodynamic disorders develop, but also symptoms of the direct effect of endotoxin on the tissues of various organs and systems are revealed.

In Bugulma in 1978, at the Children's Combine No. 34 (Head P. N. Yakimova), specialized groups were organized for the treatment of children with strabismus and amblyopia. Indications for treatment were all types of friendly strabismus with moderate and high degree amblyopia with any type of fixation.

It is known that in children diagnosed with "undifferentiated oligophrenia", who make up a significant part of the contingent of auxiliary schools, oligophrenia is often caused by various metabolic disorders. Currently, the number of nosological units associated with such shifts is constantly increasing. One of the pathological conditions leading to disorders of psychomotor development is phenylketonuria (PKU), or pyruvic oligophrenia.

Morbidity with temporary disability is one of the important and highly informative criteria characterizing the health of workers, as well as the effectiveness of medical and recreational work. In our country, its accounting was introduced in 1925. Thanks to this, it became possible to specifically and rationally plan the entire range of relevant socio-economic measures. The almost 60-year history of the study of SVT shows that at present it has undergone significant structural changes, and the curve of the dynamics of the incidence rate over the years has numerous ups and downs, the causes of which are not always explicable. As it is known, the level of sound is extremely sensitive to the changing socio-economic living conditions of the population. Therefore, this problem goes far beyond healthcare and covers almost all spheres of people's life.

Our goal was to develop a method for selecting patients with lumbar osteochondrosis for dispensary observation in a large industrial enterprise. 474 workers aged from 19 to 60 years with work experience from 3 to 20 years or more were examined according to the standard neuro-orthopedic technique [6] using tensoalgimetry [Ia] and curvimetry [5]. For a comprehensive assessment of the identified clinical manifestations of diseases, the disease severity coefficient (CVB) was used [7]. Based on these methods, 158 (33.4%) patients were diagnosed with lumbar osteochondrosis in remission. In order to identify patients at risk, we organized a three-year dynamic follow-up of the remaining 316 (66.7%) practically healthy individuals. During this time, 156 people developed symptoms of lumbar osteochondrosis. These individuals were assigned to the risk group by us. Thus, all the examined were retrospectively divided into three groups: the 1st consisted of practically healthy (160), the 2nd was a risk group (156) and the 3rd included patients with lumbar osteochondrosis (158).

The frequency of isthmic-cervical insufficiency (ICN) ranges from 10 to 30%. Its pathogenesis has not been studied to date, but it has been established that a certain role belongs to infectious pathology. Drug treatment (antibiotics, antiseptics) often has only a temporary effect: there is a change of some types of conditionally pathogenic microbes by others.

On May 22, 1983, Raisa Sharafutdinovna Abdrakhmanova, Doctor of Medical Sciences, Professor of the Department of Therapy of the Faculty of Medicine of the Kazan Medical Institute, celebrated her 60th birthday and 35 years of medical, scientific, pedagogical and social activity.