Vol 65, No 6 (1984)

Current problems of neonatology


The problem of pathology of newborns is one of the most urgent in pediatrics. According to statistics from various countries, neonatal diseases occupy one of the first places in the structure of child mortality, therefore their prevention is extremely important in reducing child mortality. In our country, much attention is paid to the antenatal protection of the fetus, the prevention of diseases of newborns, improving the quality of care for newborns and premature babies, which leads to a decrease in their morbidity and mortality. As a result of the measures taken to organize specialized medical care for pregnant women, newborns and children of the first year of life, child mortality in Tatarstan has significantly decreased over the years IX, X and current five-year plans. Further improvement of the quality of medical care for pregnant women in the conditions of a women's consultation, the detection of pathology in the early stages of pregnancy, the provision of highly qualified assistance in a maternity hospital, the creation of optimal conditions for the care of newborns at all stages of their care are one of the main reserves for reducing infant mortality.

Kazan medical journal. 1984;65(6):401-406
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Theoretical and clinical medicine

Experimental and clinical aspects of the pathogenesis of endotoxin shock

Ivanov N.R., Shankman B.Z.


The occurrence of a shock-like state in connection with an infectious disease was first reported by Laennek in 1831. More specifically, this relationship was established in 1899 [46]. The absence of a noticeable decrease in the frequency of recorded endotoxin shock in humans is due to a number of factors, the most important among which are the following: a) improvement in the diagnosis of endotoxin shock, made possible by the use of sophisticated diagnostic equipment; b) familiarity of specialists of various profiles with this nosological form; c) an increase in the life expectancy of patients with severe pathology and a decrease in general and immunological reactivity; d) the use of immunosuppressants and cytostatic drugs for allergies, malignant neoplasms, which facilitates the development of infectious pathology; e) frequent obstetric pathology, accompanied by the birth of children with reduced resistance; f) widespread use of antibiotic therapy, leading to the emergence of antibiotic-resistant microbes; it should also be noted here that when treating septic foci and infectious diseases with antibiotics, there is a danger of massive entry into the bloodstream of endotoxins released from dead microorganisms; g) carrying out complex diagnostic manipulations and surgical operations that open the entrance gates for infection.

Kazan medical journal. 1984;65(6):406-411
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Shock and combined chest injury

Altunin V.F., Krylov V.E.


Combined chest injuries in many cases are a serious threat to the life of the victim. Violation of the frame, loss of tightness of the chest, reduction of the internal volume of the chest cavity due to rib fractures, accumulation of blood or air in the pleural cavities with pain impulses attached to them, coming from injuries of other localizations, create conditions for disruption of vital functions of the body and the development of severe shock.

Kazan medical journal. 1984;65(6):411-413
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Prospects of neurotropic pharmacotherapy of traumatic shock

Bazarevich G.Y., Lazareva L.V., Kamburg R.A., Beilin M.A.


According to world statistics, severe mechanical injuries rank third among the causes of death, and in the group of people younger than 45 years — the first. 2.5% of all injuries are accompanied by shock, and one in four of the victims dies. In this regard, the problem of traumatic shock occupies one of the prominent places in medicine, and research in this area is gaining more and more scope and depth every year. One of the insufficiently studied aspects of this problem is the issue of the prevention of traumatic shock. This determines the urgent need to develop schemes for providing first medical and qualified assistance to victims.

Kazan medical journal. 1984;65(6):413-415
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Mechanisms of changes in the oxygen transport function of erythrocytes in patients with chronic ischemic heart disease complicated by circulatory insufficiency

Lukyanov V.F., Zakharova N.B., Goncharova L.N., Rubin V.I.


One of the early and characteristic reactions to hypoxia, including in patients with circulatory insufficiency, is an increase in the level of 2,3-diphospho-glycerate (2,3-DPH) of erythrocytes [4, 6, 10, 12], which is formed in the Rapoport - Lubering cycle and is an offshoot of glycolysis of erythrocytes. The features of the interaction of hemoglycolysis and the Rapoport — Lubering cycle in patients with circulatory insufficiency have not been studied before. Knowledge of such features makes it possible to determine the degree of participation of erythrocytes in the development of hypoxia in patients at different stages of circulatory insufficiency.

Kazan medical journal. 1984;65(6):421-424
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The importance of hemosorption in the treatment of urgent surgical patients

Nikolaev G.M., Nechunaev L.M., Mukhametzyanov S.A., Radaykin V.V., Tuishev R.I., Chuprin V.G., Pustylnik L.I., Hajiyev A.N.


The method of hemosorption is based on the ability of activated carbon and ion-exchange resins to completely remove from the blood or reduce the concentration of exogenous toxins and toxic metabolites accumulated in various pathological conditions.

Kazan medical journal. 1984;65(6):416-418
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Clinic and treatment of sepsis in young children

Nadyrova G.G., Nagimova F.I., Podryadnov G.S.


Sepsis remains one of the main problems of infectious pathology of young children. A number of authors believe that it occurs more often in children in the first three months of life and proceeds mainly in the form of septicemia.

Kazan medical journal. 1984;65(6):418-421
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The effectiveness of mebicar in chronic coronary heart disease

Kamburg R.A., Valimukhametova D.A.


Modern pharmacotherapy of chronic coronary heart disease (HIBS) is based on the use of two main groups of drugs — nitrates and beta-blockers. The effectiveness of other drugs in the complex treatment of this disease is being reviewed and constantly debated [1, 2]. The treatment of HIBS, combined with bradycardia, circulatory insufficiency, bronchospastic conditions, intolerance or contraindications to the use of nitrates and beta-blockers, is a great difficulty.

Kazan medical journal. 1984;65(6):424-426
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Surgical anatomy of internal thoracic vessels and their branches in newborns

Nicoshin L.I., Mingazov R.G.


Surgical anatomy of the internal thoracic artery in newborns is insufficiently studied. This vessel may be of interest to doctors of various specialties - traumatologists, surgeons, neuropathologists, radiologists, in particular, as a
place of insertion of a catheter for semi-selective angiography of the subclavian artery and its branches, for example, the vertebral artery. The latter is becoming increasingly important for the recognition of various pathologies associated with birth trauma of the cervical spine and its contents in newborns.

Kazan medical journal. 1984;65(6):426-429
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Chronic bronchitis in patients with destructive pulmonary tuberculosis

Smirnov G.A., Abashev I.M.


The undulating course of chronic destructive pulmonary tuberculosis usually leads to the formation of pneumosclerosis, against which a chronic nonspecific infection develops. Manifestations of the latter often become leading in the clinical course of the disease, complicate the diagnosis of exacerbations of a specific process [4, 6, 8] and reduce the ability to work of patients [2J.

Kazan medical journal. 1984;65(6):429-432
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Destructive pneumonia in the tuberculosis clinic

Anastasyevka V.S., Smirnov G.A., Fattakhova P.M.


In recent years, there has been an increase in the number of pneumonia occurring with an atypical clinical picture, the prolonged and complicated course of which can be the cause of diagnostic errors. Destructive pneumonia, mostly without a pronounced clinic of acute lung abscess, is often mistaken for infiltrative pulmonary tuberculosis in the decay phase, especially with their upper lobe localization.

Kazan medical journal. 1984;65(6):433-436
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The importance of hysterosalpingography in the diagnosis of tuberculosis of the female genital organs

Mammadova M.D., Ismailova S.D.


According to literature data, inflammatory diseases of tuberculous etiology of the genital sphere in women are often observed [3, 5]: 15-20% of infertile women [4] and 8.6% of patients with menstrual dysfunction [2]. Over the past decade, the clinical picture of this disease has changed. Latent forms prevail, which are characterized by the duration of the course, lead to a violation of various functions of the female body and, above all, to persistent infertility, sometimes to disability and disability. Diagnosis of the disease is especially difficult when the fallopian tubes are affected. In this regard, hysterosalpingography, bicontrast gynecography, an overview image of the abdominal cavity to determine calcifications in the lymph nodes of the pelvis and appendages of the uterus turned out to be very valuable methods for detecting tuberculous lesions of the genitals of a woman.

Kazan medical journal. 1984;65(6):437-438
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About complications of childbirth in patients with hypertension

Stolnikova I.I.


Of the complications, weakness of labor activity was more often detected: primary — in the control group (2.9%) and in patients with hypertension (4.9%), secondary - in 1.7% and 5.3%, respectively. Premature detachment of the normally located placenta occurred in 1.4% of patients. Bleeding in the subsequent and early postpartum periods was also more often observed in patients with hypertension.

Kazan medical journal. 1984;65(6):438-441
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Rehabilitation of reproductive function after ovarian surgery

Kapelyushnik N.L., Slepov M.I., Minnibayeva P.M., Katanova S.I.


Benign ovarian tumors occur mainly at a young age. Their timely removal serves as an effective prevention of ovarian cancer. There are few works devoted to the study of the reproductive function of women after conservative ovarian surgery. Research by N. I. Egorova (1966) suggests that the removal of one ovary is not indifferent to a woman's body, it can cause disorders of neuroendocrine regulation with violation of menstrual and reproductive functions. Other authors also point to the need for maximum conservatism in ovarian surgery for benign tumors and tumor-like formations in women of reproductive age [2, 3].

Kazan medical journal. 1984;65(6):441-443
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Our experience of X-ray examination of traumatological patients

Kamalov I.I., Pavlycheva V.I.


Despite the fact that the issues of X-ray examination of neurosurgical and traumatological patients have been studied for a long time, to date, a number of aspects of this problem remain insufficiently investigated.

Kazan medical journal. 1984;65(6):443-446
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Pathogenetic principles of treatment of elbow joint injuries

Karalin A.N., Semenov V.D.


Treatment of intra-articular fractures is a complex problem. When choosing a treatment method, one should proceed from the severity of the injury, age, gender of the victim, etc. Studies show that post-traumatic changes in the joint are associated with disorders in the macro- and microcirculation system [1]. Dynamic observation of changes in regional microcirculation, carried out by us using the method of radiocirculography, allowed us to establish a relationship between the severity of the injury of the elbow joint, the type of injury and the method of treatment.

Kazan medical journal. 1984;65(6):446-447
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Operative correction of congenital hip dislocation in children

Abakarov A.A.


The main pathogenetic link in congenital hip dislocation is dysplasia of all elements of the hip joint [1, 2]. Many methods of surgical treatment of patients with this pathology have been proposed. The development and implementation of gentle operations in the clinic with the preservation of acetabulum cartilage, the elimination of compression in the joint significantly improved the results of treatment. However, the percentage of aseptic necrosis of the femoral head remains high [3, 4].

Kazan medical journal. 1984;65(6):448-449
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Hergastroplasty in combined gastrectomy

Polyakov M.A., Klimenkov A.A., Patyutko Y.I.


The question of the scope of surgical intervention in common forms of stomach cancer remains complex, controversial and unresolved. There is a lively discussion in the literature between specialists who adhere to extreme points of view. As the methods of preoperative preparation, anesthesia, surgical techniques and postoperative management of patients with gastric cancer are improved, combined gastrectomies are increasingly used. According to V. N. Sagaidak (1969), in inoperable stomach cancers, true tumor ingrowth into distant neighboring organs was found only in 50% of patients. According to Nicolosi (1971), extended radical intervention is justified in gastric cancer complicated by ascites, peritoneal dissemination, jaundice, liver metastases, Krukenberg tumor, cancer ingrowth into the colon and into the anterior abdominal wall. The life of such patients can be prolonged, according to the author, risky, "crippling" operations.

Kazan medical journal. 1984;65(6):449-451
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Urodynamics of the lower urinary tract in megaureter

Tereshchenko A.V., Seymivsky D.A.


Neuromuscular dysplasia of the ureter, including the ureteral segment, plays an essential role in the genesis of disorders that determine the development of megaureter in children [1, 2, 3, 5].

Kazan medical journal. 1984;65(6):452-454
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Clinic and treatment of infectious and toxic shock in meningococcal infection

Enaleeva D.S.


Meningococcal infection has several clinical forms that manifest themselves independently or in combination. The most life-threatening are generalized forms of the disease that occur when meningococcus overcomes the protective barrier of the nasopharynx and enters the bloodstream.

Kazan medical journal. 1984;65(6):454-457
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Clinical experiences

Experience in the treatment of injuries to the tendons of the deep flexors of the fingers and hand

Pavlov V.S.


Treatment of open injuries of fingers and hands remains an urgent problem of traumatology.

Kazan medical journal. 1984;65(6):458-459
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A case of meningococcal infection with infectious-toxic shock

Tagirov N.S.


In recent years, we have often encountered severe cases of meningococcal infection, which require an individual approach from the doctor.

Kazan medical journal. 1984;65(6):457-458
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Medical examination of disabled people due to injuries in city polyclinics and medical units

Kozin N.D.


Analyzing materials on disability caused by injuries, according to the city of Saransk from 1970 to 1980, we found that, despite fluctuations in the intensive indicators of primary disability for individual years, there is a distinct tendency to increase them.

Kazan medical journal. 1984;65(6):462-463
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Comparative evaluation of methods of treatment of diaphyseal fractures of the lower leg bones

Strizhakov N.V., Ovsyannikov V.A., Kudryashov V.A.


For 5 years, 195 patients (146 men, 49 women) with diaphyseal fractures of the lower leg bones were treated in the traumatology department. There were 60 open fractures and 135 closed fractures. 155 (79.5%) patients were of working age (20-60 years).

Kazan medical journal. 1984;65(6):460-461
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To the method of lavsanoplasty of knee ligaments

Karpov S.V.


When plasticizing the ligaments of the knee joint in order to form a single ring-shaped ligament from dacron tape, we sew its ends together, forming a closed system. This technique is used by us for simultaneous restoration of the cruciate and lateral ligaments of the knee joint. Access to the joint is carried out by an internal or external parapatellar incision. In the formation of the anterior cruciate and internal lateral ligaments (em. fig.) lavsan tape is carried out through channels in the outer condyle of the femur and the inner condyle of the tibia and its end is brought to the inner surface of the tibia. The other end of the tape is also brought to the inner surface of the thigh through the horizontal supracondylar canal in the femur. Then both ends of the tape are connected, stretched as much as possible and sewn together. Thus, an annular ligament is created, which evenly distributes the load on the dacron ribbon and the bone condyle channels.

Kazan medical journal. 1984;65(6):459-460
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Features of the course and management of childbirth with anomalies of labor activity

Talatina L.L.


We analyzed 1,610 births that took place in obstetric clinic No. 1 of Kazan GIDUV in 1981. 105 (6.5%) of them were complicated by anomalies of labor activity. The most frequent type of pathology of labor activity was its weakness (6.0%): primary - in 77 (4.8%), secondary - in 13 (0.8%). Discoordinated labor activity was diagnosed in 15 (0.9% of women in labor), of which 13 had functional cervical dystocia, 2 had anatomical.

Kazan medical journal. 1984;65(6):461-462
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Physical development of newborns in Yoshkar-Ola

Nikulina N.G., Kamaeva A.A., Khaletova S.S.


The aim of the work was a comparative study of the physical development of newborns in Yoshkar-Ola in 1961 and 1981. The dynamics of indicators of length and body weight of newborns is presented in Table 1.

Kazan medical journal. 1984;65(6):463-464
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History of medicine

Professor Andrey Fedorovich Agafonov

Mikhailov M.K., Bashirova D.K.


1984 marks the 100th anniversary of the birth of the Honored Scientist of the RSFSR, Professor Andrey Fedorovich Agafonov, a well-known infectious diseases doctor, scientist and health care organizer.

Kazan medical journal. 1984;65(6):464-465
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VIII All-Union Congress of Hygienists and Sanitary Doctors (Vilnius, October 29-31, 1984)

Gimadeev M.M.


The program of the congress was devoted to discussing the tasks of the hygienic community in the light of the decisions of the XXVI Congress of the CPSU, subsequent plenums of the Central Committee of the CPSU and resolutions of the Central Committee of the CPSU and the Council of Ministers of the USSR "On additional measures to improve public health".

Kazan medical journal. 1984;65(6):466-466
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