


Vol 64, No 5 (1983)



Clinical medicine
Surgical removal of acute occlusions of the abdominal aorta and its branches
Abstract
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].



Possibilities of surgical treatment of injuries of the main veins
Abstract
Surgical treatment of damage to the hollow and portal veins and their main tributaries is a little-studied and urgent problem of emergency vascular surgery. Statistical data on the frequency of damage to the largest veins are contradictory. During the Great Patriotic War, the frequency of isolated venous wounds was 13.7% of all vascular injuries [5], 0.3% of those killed on the battlefield died from bleeding from the iliac veins [4]. In peacetime, 8% of victims with penetrating abdominal wounds had damage to the vena cava or iliac veins [14].



Preoperative preparation of patients with ulcerative form of postthrombophlebitic syndrome on an outpatient basis
Abstract
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.



Electrical stimulation in the treatment of trophic ulcers of the lower extremities
Abstract
The most common cause of the development of trophic ulcers of the lower extremities is chronic venous insufficiency, which accounts for 85 - 92% of lesions [1, 4]. In the treatment of patients with trophic ulcers, the surgeon focuses on two key points: correction of perverted venous blood flow in the limb and stimulation of regenerative processes in the ulcer area. If in matters of surgical correction of venous circulation, thanks to the achievements of phlebology, there are fewer and fewer controversial and unresolved issues every year, then the problem of local treatment of ulcers is still far from final resolution. In this regard, the search for new ways of treating trophic ulcers is justified.



Diagnostic and prognostic value of determination of oxyproline in blood in patients with acute myocardial infarction
Abstract
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.



Complex therapy of circulatory insufficiency with protein hydrolysates, retabolil and strofantin
Abstract
It has been experimentally established that an increase in the efficiency of cardiac glycosides can be achieved when they are combined with stimulators of protein synthesis and nucleic acids that can affect the processes of protein anabolism in the myocardium [3, 5, 6]. At the same time, stimulation of protein synthesis (proper anabolic effect) and blockade of protein breakdown (anti-catabolic effect) of anabolic steroids, apparently, can be enhanced by their combination with protein hydrolysates or mixtures of amino acids.



Clinical assessment of the functional state of the myocardium in artificial hyperthermia
Abstract
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.






The effect of semipermeable membranes on the contact activation of blood clotting during programmed hemodialysis
Abstract
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.



B2-microglobulin as an indicator of proteinuria in chronic kidney diseases
Abstract
Currently, the issues of studying the physiological role of B2-microglobulin attract the attention of many researchers, since it is a physiological component of all body fluids In recent years there have been reports about the leading role of the kidneys and, above all, the tubular nephron in the metabolism of B2-microglobulin. This circumstance served as the basis for the parallel determination of the content of β2-microglobulin in blood and urine to study a number of renal functions. The small molecular weight (11,800 daltons) and the small size of β2-microglobulin allow it to pass through an intact glomerular membrane. However, normally almost all (99.5%) of the filtered β2-microglobulin is absorbed and metabolized in cells



Testosterone in the blood of men with diabetic nephropathy
Abstract
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].



Heredity in the development of mental disorders in cerebral atherosclerosis
Abstract
Cerebral atherosclerosis is the main reason for exclusion from the social life of elderly people, and the occurrence of psychosis is most often the first signal of the "fatal course of cerebral vascular disease" [1]. In this regard, quantitative assessments of the role of unfavorable hereditary burden as a risk factor in the development of mental disorders in cerebral atherosclerosis are of importance.



Clinical and electrophysiological assessment of chronic alcoholic psychoses
Abstract
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.



Excretion of catecholamines in urine with restless behavior of women in labor
Abstract
Psychoprophylactic preparation for childbirth, adopted in the medical service system, gives fruitful results, but in some women in labor it is not always effective [3]. We were interested in the question why, after a full course of preparation for childbirth in a women's clinic, some women in labor with a balanced nervous system still behave restlessly, and the sedatives used are not always effective.



Angiotensometry during operations on the uterus and appendages
Abstract
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.



The experience of reflexotherapy of shoulder periarthritis
Abstract
Shoulder periarthritis ("shoulder pain", "painful shoulder", shoulder periarthritis, shoulder joint periarthritis) is a problem relevant for orthopedists, neuropathologists and therapists. This is explained by the fact that this pathology occurs quite often, it is difficult to explain the etiological and pathogenetic mechanisms of occurrence and for treatment.



Effect of sodium fluoride on vestibular function in patients with otosclerosis
Abstract
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.



Neurological disorders in open-angle glaucoma
Abstract
The combination of glaucoma with damage to the central nervous system is quite common [4, 11]. The genesis of violations of the hydrodynamics of the eye in such cases remained unclear for a long time. It was assumed that for the development of open-angle glaucoma, in addition to the presence of dysfunction of the higher autonomic centers [1, 2, 7, 9], the impact of other factors is also necessary. A number of authors [3, 5, 8, 10] have found that cervical osteochondrosis causes a cervically caused increase in intraocular pressure.



Oropharyngeal anesthesia with azeotropic mixture in pediatric ophthalmic surgery
Abstract
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.



Circulating immune complexes in children with bronchopulmonary pathology
Abstract
Autoimmune disorders play an essential role in the pathogenesis of bronchopulmonary pathology [2], one of which is the occurrence of soluble immune complexes circulating in the bloodstream [7]. The literature data on the role and significance of circulating immune complexes (CEC) mainly concern the pathology of adults [4, 8]. In children's practice, only isolated reports on the content of CEC in diabetes mellitus, sepsis and blood diseases are given [1, 3, 6].



Laparoscopic cholecystostomy in acute diseases of the extrahepatic biliary tract
Abstract
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].



Clinical experiences
About intraventricular blockades
Abstract
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.



Lifetime diagnosis of primary atrial tumor
Abstract
At the age of 42, she was first admitted to the therapeutic department of the 7th City Clinical Hospital on July 26, 1978 with complaints of palpitations, shortness of breath when walking, compressive pains behind the sternum. She considers herself ill since May 1978. Shortly before that, she suffered a sore throat. The reason for hospitalization was a sudden attack of suffocation that happened on the way to work. With the diagnosis of "acute heart failure", the ambulance delivered the patient to the department. Based on the data of physical, laboratory and instrumental examination, the diagnosis was made "rheumatism, inactive phase, stenosis of the left atrioventricular orifice, No-1". At the first hospitalization, it was noted that the auscultative mitral melody with rather pronounced subjective manifestations was not accompanied by radiological, electrocardiographic and physical signs of expansion of the boundaries of the heart. In this regard, the patient was re-hospitalized after 2 months.



Purulent mediastinitis with a successful outcome
Abstract
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.



Correction of blood rheological properties with acetylsalicylic acid in patients with diabetes mellitus
Abstract
There were 105 patients with diabetes mellitus under observation (women - 62, men-43, age - 17-72 years). The rheological properties of their blood were studied: the viscosity of whole blood and its plasma, hematocrit, protein spectrum and serum lipids.



Intramural hemodynamics and motor activity of the stomach and duodenum after vagotomy
Abstract
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).






The state of hemostasis in salmonella intoxication
Abstract
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.






Experience in organizing the treatment of strabismus and amblyopia in children
Abstract
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.






Phenylketonuria among auxiliary school students
Abstract
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.



Social hygiene and healthcare management
Morbidity with temporary disability in the Tatar ASSR
Abstract
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.



Work experience on the method of continuous medical examination of the female population
Abstract
We conducted an analysis of preventive examinations of the female population of the Aznakaevsky district after actively identifying women who need treatment or systematic observation of an obstetrician-gynecologist for health reasons. Preventive examinations by the method of continuous medical examination were due to the industrial and agricultural profile of this area, in which the female population prevailed.



Medical examination of patients with lumbar osteochondrosis
Abstract
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).



New methods of diagnosis and treatment
Ring for the treatment of isthmic-cervical insufficiency
Abstract
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.



Jubilees
Professor Raisa Sharafutdinova Abdrakhmanova
Abstract
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.



Professor Leonid Mendeleevich Demner
Abstract
August 3, 1983 marked the 60th anniversary of the birth and 35 years of medical, scientific, pedagogical and social activities of the head of the Department of Orthopedic Dentistry of the Kazan Medical Institute named after S. V. Kurashov, Doctor of Medical Sciences, Professor Leonid Mendeleevich Demner.


