Vol 72, No 1 (1991)
Basic differential diagnostic criteria and modern treatment strategy for the most important anemias
Abstract
Anemias are defined as conditions caused by a decrease in the concentration of hemoglobin and / or the number of red blood cells per unit volume of blood. They are always secondary, since they are either a consequence of the underlying disease, or develop as a result of a known cellular (molecular) defect.



Theoretical and clinical medicine
Ultrasound scanning in the diagnosis of lesions of parenchymal organs and extramedullary foci of hematopoiesis in patients with acute non-lymphoblastic leukemia
Abstract
An ultrasound study of parenchymal organs, retroperitoneal space and vessels of the biliary system was carried out in 70 patients with acute non-lymphoblastic leukemia. The sonographic criteria of liver and spleen lesion, characteristic for different phases of acute leukemia, were revealed. Changes in the size and echostructure of the liver and spleen, the thickness of the wall of the gallbladder, vessels of the portal system, the presence of extramedullary foci of hematopoiesis should be used as criteria for the completeness of remission of acute leukemia.






On the need to correct microcirculation in patients with acute pneumonia and chronic bronchitis
Abstract
The parameters of microcirculation of the bulbar conjunctiva, rheological properties of blood and some indicators of hemocoagulation in dynamics were studied in 40 patients with acute pneumonia and 34 patients with chronic bronchitis. The importance of these studies for assessing the severity and completeness of the inflammatory process in the bronchopulmonary system, as well as the effectiveness of the therapy for these diseases is shown.



On the possibility of treating edema by the method of "dry" immersion
Abstract
The results of the use of therapeutic "dry" immersion (LSI) in the complex therapy of 10 patients with refractory edematous syndrome of various etiologies are presented, and the effect of the method on some indicators of central hemodynamics is studied. It has been established that LSI sessions lasting from 2 to 6 hours potentiate the action of diuretic drugs and help compensate for the condition of patients. LSI session has a positive effect on central hemodynamic parameters.



Immunoglobulins E in the clinic and outcomes of viral hepatitis B in children with allergically altered reactivity
Abstract
In 60 children aged 3 to 14 years old with viral hepatitis B, the clinical picture of the disease and the content of serum IgE were studied. In children with allergically altered reactivity, significantly increased and prolonged (more than 3 months) hyperimmunoglobulinemia E can be considered a prognostically unfavorable sign.



Cardiointervalography in predicting the state of premature babies in the early neonatal period
Abstract
The results of a prospective examination of 65 premature babies showed that the absence of disorders in the condition of a premature baby using the proposed analysis of cardiointervalograms can be predicted with an accuracy of up to 95%, and their presence - up to 97%. The accuracy of the differentiated determination of the severity of the condition of a premature newborn averaged 73%. The developed cardiointervalographic indicators have a much greater sensitivity than specificity, which is important in screening studies.



Immunological aspects of long-term insulin-dependent diabetes mellitus
Abstract
The results of a comprehensive study of immune homeostasis in 45 patients with long-term insulin-dependent diabetes mellitus are presented. In 50% of the examined patients, the absolute number of leukocytes was reduced, in a third - the number of lymphocytes and the total population of T-lymphocytes, in every second patient - the number of T-helpers and in a quarter - T-suppressors, and quite significantly. In 50% of patients, a sharp decrease in the immunoregulatory index, a significant decrease in the absolute number of B-lymphocytes were found. A significant increase in the content of activated T-lymphocytes and a decrease in the number of null lymphocytes were revealed, there was a disimmunoglobulinemia. In 50% of patients, the activity of the C3 component of the complement and the level of the CEC were increased.



Neutrophilic phagocytosis in influenza in children
Abstract
Peculiarities of restoring the parameters of the phagocytosis system in 58 children aged 5 days to 3 years with influenza were studied. A pronounced immunosuppressive effect of the influenza virus on the functional state of neutrophilic granulocytes and a slow recovery of their function, especially in the course of the disease in children of the first year of life, were revealed. A decrease in the phagocytic reserve during clinical recovery was combined with frequent recurrent illnesses in children, which can serve as one of the criteria for a high risk of forming a group of frequently ill children who have had influenza.



Study of the personality of patients with alcoholism at various stages of the disease
Abstract
In the last two decades, many works have appeared in the scientific literature devoted to the experimental psychological study of the personality of patients with alcoholism [3–6]. In the most fundamental of them [6], the main personality types were identified on a large sample of alcoholics using the MMPI technique. However, it remains unclear what characterological features were introduced in the process of alcohol abuse, since all patients with alcoholism were subjected to research, regardless of alcohol "experience", the structure and rate of the disease. At the same time, in practice, it is very important to assess the personality of patients with alcoholism, the ratio of characterological features at various stages of the disease.



To the clinic of alcoholism formed in the late period of neuroinfection
Abstract
The clinic of alcoholism that developed in 69 patients against the background of long-term consequences of neuroinfection was studied. It has been established that the formation and course of such alcoholism occur at an accelerated rate, and the organic brain disease itself tends to progress.



Features of nicotinism in patients with schizophrenia
Abstract
Based on a survey of 60 patients with schizophrenia and 25 patients with epilepsy, the structure of nicotinism is described; the motivating components of smoking are analyzed. Correlations were found between an increase in smoking intensity and an increase in psychotic anxiety, as well as the appearance of symptoms of an neuroleptic syndrome (in particular, akathisia). The structure of nicotinism in patients with schizophrenic defect was studied. Cigarette addiction in this group reflects the mechanism of schizophrenic dissolution of the psyche and can be considered as an integral part of painful disorders of the volitional process.



Structural and dynamic features of verbal hallucinosis in organic lesions of the temporal region of the brain
Abstract
31 patients with organic lesions of the temporal region of traumatic, vascular and infectious origin were examined from the standpoint of structural and dynamic analysis, which showed that the lesion of the temporal region is accompanied by polyvocal complex stable hallucinosis.



Tactics of a neurosurgeon in the acute period of complicated spinal injury
Abstract
A comprehensive examination of 207 patients with spinal and spinal cord injuries in the acute period of the disease was carried out. 120 patients were operated on during the first 2 days after admission to the hospital. 87 patients received conservative treatment. The regression of the neurological deficit and the results of treatment for the restoration of function were the best in the group of operated patients.



Consideration of risk factors in the choice of surgical tactics in acute bleeding from a chronic duodenal ulcer
Abstract
A system for predicting the outcomes of acute bleeding from a chronic duodenal ulcer is presented. With the help of single risk factors and their combinations, indications for blood transfusion, risk factors for recurrent bleeding, severity of patients (life-threatening bleeding), indications for emergency surgery, risk factors for drug treatment and emergency surgery were determined. Based on this system, 163 people were treated (main group). Compared with a group of 418 patients (control group), a decrease in mortality and volumes of transfused blood was achieved.



Therapeutic tactics in colonic diverticulosis complicated by bleeding
Abstract
Of the 526 patients with colonic diverticulosis, severe bleeding was observed in 80 (15.2%) people, mainly in the elderly. Emergency surgical interventions were required in 13.8% of patients. Surgical tactics are described depending on the prevalence of diverticulosis and the intensity of bleeding.



About surgical treatment of Meckel's diverticulum
Abstract
Periodically, detailed materials on Meckel's diverticulum appear in the literature. In addition, reports on single and casuistic observations of pathological conditions caused by this congenital defect are often published in surgical journals. These materials quite well cover the issues of history and embryogenesis, the clinic of pathological conditions and their treatment; examples of various combinations of Meckel's diverticulum with other diseases, its complications, etc. are given. At the same time, the authors note difficulties, especially diagnostic ones: before surgery, Meckel's diverticulum is detected in rare cases [1], while mortality reaches 16.6–24% [ 1, 7]. All these diagnostic miscalculations are probably due to the fact that Meckel's diverticulum is quite rare. According to A. A. Rusanov [5] during the autopsy of corpses, it is found in approximately 2% of cases, and according to V. Toshovsky and O. Vikhitil [6] - in 0.3-2.3%. In practical surgery, each surgical finding of this pathology causes a lively discussion, so all reports of Meckel's diverticulum are very interesting.



Clinical significance of the variant anatomy of the left adrenal and testicular (ovarian) veins
Abstract
Three variants of the confluence of the central vein of the adrenal gland with respect to the testicular vein were identified. With nephrectomy on the left without selective ligation of the renal vessels, a decrease in the level of adrenal cortical hormones (aldosterone, cortisol) was found in the first 10 days after the intervention. Targeted ligation of the left renal vein distal to the orifice of the testicular veins is recommended, which is important for the prevention of adrenal insufficiency in the early postoperative period.



Surgical treatment of paralytic instability and paralytic deformities of the knee joint
Abstract
There were 2675 patients with the consequences of poliomyelitis, of which 773 (28.9%) had paralytic instability with deformity of the knee joint. Arthrodesis of the knee joint was performed in 316 patients, transplantation of the tibial flexors to the patella — in 235 patients. For the treatment of paralytic deformities of the knee joint, operations should be used to restore the axis of the limb and aimed at preventing gonarthrosis. New ways of treating deformities developed by the author are described.



Is pregnancy a risk factor for kidney stones?
Abstract
In the urine of pregnant women, a relatively high content of silicon was found, which increases the colloidal properties of urine and prevents the precipitation of the ingredients of urinary stones (urates, phosphates, oxalates). At the same time, it is known that during pregnancy such factors appear and increase in intensity that contribute to stone formation in the urinary tract - urinary stasis, urinary tract infection, shifts in electrolyte metabolism. A similar situation is observed in patients with silicosis, who also have a high content of silicon in the urine, but it does not reach such values as in pregnant women. For the same reason, patients with silicosis rarely develop urolithiasis. With an increase in the number of pregnancies, the risk of urolithiasis does not increase.



Reconstructive plastic surgery on the uterus and postoperative rehabilitation of patients
Abstract
Surgical treatment of 97 patients with uterine myoma and anomalies of its development was carried out. Conservative myomectomy, high supravaginal amputation, amputation of the uterus with endometrial plasty, Strassmann operation were used. In the postoperative period, physiotherapeutic methods of rehabilitation were used, which made it possible to reduce the postoperative period and restore reproductive and menstrual function in women.



Reviews
Possibilities of doppler echocardiography in heart diseases
Abstract
Doppler echocardiographic study allows you to determine the direction of the flow, its nature (laminar or turbulent) and speed in the projection of all heart valves. The parallel use of Doppler echocardiography compensates for the shortcomings of one- and two-dimensional methods in detecting valvular regurgitation, helps to detect signs of interventricular and interatrial shunting in case of suspected congenital heart disease, and allows non-invasive calculation of transvalvular pressure gradients in heart disease. The correct assessment of hemodynamics and valvular apparatus of the heart, the exact localization of the studied flow contribute to the objectification of the assessment of the pathological process. With combined heart defects, doppler echocardiography is a more informative method than radiography and one- and two-dimensional echocardiography, and may be the method of choice when deciding on the indications and nature of the surgical correction of the defect.



Therapeutic tactics for postoperative reflux gastritis
Abstract
Gastritis of the operated stomach has been known since the time of the first resections and gastroenterostomies. The term "reflux gastritis", or "postoperative alkaline reflux gastritis", has recently become widespread, which made it possible to look at the problem of its prevention and treatment from a new perspective.



The role of the autonomic nervous system in the regulation of nonspecific immune responses of the body
Abstract
Recently, interest has increased in studying the role of the nervous system in the regulation of immunological and nonspecific mechanisms. Nonspecific resistance factors and specific immune responses of the body to antigen administration are closely related. Lymphocytes and macrophages take part not only in immunogenesis, but also are regulators of morphogenesis, biochemical and physiological reactions. Insufficiency of complement synthesis is accompanied by immunodeficiency. Removal of the thymus reduces the activity of cellular (phagocytosis) and humoral (complement, lysozyme, ß-lysines) factors of nonspecific resistance of the organism. The functioning of nonspecific resistance mechanisms is of great importance in the formation of an immune response both at the beginning of a specific process, its development, and in the effector phase and the outcome of the immune process. Therefore, changes in nonspecific resistance factors are regarded both as an indicator of the severity of the immune process, and as an indicator of the activity of the body's protective and adaptive reactions during antigenic irritation.



Short articles
On the inappropriateness of antibiotic therapy for uncomplicated forms of acute respiratory viral infection in children
Abstract
As you know, antibiotics do not affect viruses, but it is not possible to completely avoid the use of antibiotics in ARVI. So, they are indicated in the event of bacterial complications (pneumonia, otitis media, etc.). Literature data on the use of antibiotics for uncomplicated bacterial infection forms of ARVI are contradictory. There are recommendations to prescribe antibiotics and other antibacterial drugs in order to prevent the activation of opportunistic microflora or the prevention of superinfection in a hospital setting. At the same time, antibiotics are far from indifferent to the child. They can have a direct toxic, sensitizing effect, delay the development of immunological reactivity. No less significant is the fact that with the frequent use of antibiotics, microorganisms become resistant to them.






Intravascular microcoagulation in hypertension
Abstract
The unrelenting interest in the pathology of hemostasis in hypertensive patients is explained by the increased frequency of thrombohemorrhagic complications in them. The results of studies on violations of various links of hemostasis in hypertension are ambiguous and sometimes contradictory.



Evaluation of the effectiveness of surgical methods for the treatment of uncomplicated compression fractures of the spine
Abstract
In the clinic of traumatology and pediatric surgery of the Chuvash University named after I. N. Ulyanov, from 1973 to the present, 704 patients with uncomplicated compression fractures of the spine (NCF) in the lower thoracic and lumbar regions have been treated. Of these, 126 (18%) patients underwent surgical fixation of the posterior section of the damaged area of the spine. The patients were aged 16 to 60 years.



Microsurgical and physical methods of treatment of patients with lymphostasis of the lower extremities
Abstract
Currently, a lot of experience has been gained in the treatment of chronic lymphatic insufficiency by forming direct anastomoses (LVVA) or lymphonodulovenous anastomoses. Most surgeons apply LVVA in secondary forms of lymphedema due to impaired patency of the lymphatic vessels or nodes after trauma, surgery, inflammation, or radiotherapy. At the same time, there are reports of surgical treatment of primary lymphedema.



Hemisplenectomy for ruptured splenic cyst
Abstract
The threat of developing immunodeficiency and various purulent-septic complications after splenectomy encourage surgeons to perform organ-preserving operations on this organ. In the clinic, 3 patients were operated on for spleen cysts. The correct diagnosis before surgery for ruptured cysts can only be established using laparoscopy (performed in 2 patients) and angiography. The operation of choice for this pathology is splenectomy. We give a description of the organ-preserving operation for ruptured spleen cysts.



Trophoblastic beta1-glycoprotein in puerperas after caesarean section
Abstract
Among pregnancy proteins, trophoblastic beta1-glycoprotein (TBG), which has immunosuppressive activity, is of great importance. Reports on the content of TBG in the postpartum period are rare, and after caesarean section there are no reports at all.



The state of the blood coagulation system in patients with thyrotoxicosis
Abstract
The state of the blood coagulation system in thyrotoxicosis has been studied for a long time, but there is still no unambiguous opinion on this issue: both hypocoagulable and hypercoagulable changes in hemostasis have been stated. There is an opinion that blood clotting in this disease does not change at all.



Conferences
Topical issues in the study of tick-borne encephalitis and hemorrhagic fever in their natural foci (Izhevsk, September 11-12, 1990)
Abstract
The topic of discussion at the last Republican Scientific and Practical Conference was the problem of tick-borne encephalitis and hemorrhagic fever (HFRS). The following issues were discussed: 1) ways to improve prevention and anti-epidemic measures; 2) features of the epidemiology and clinic of these natural focal infections; 3) new in the diagnosis and treatment of these infections; 4) issues of social and clinical rehabilitation of patients with tick-borne encephalitis and HFRS.



Interregional educational and methodological conference on teaching at the medical university of valeology (Perm, October 10-11, 1990)
Abstract
At the conference, reports were heard and discussed on the organizational and methodological aspects of teaching the science of health - valueology at a medical university. Recommendations are given for systematization, as well as for increasing the theoretical and applied orientation of the knowledge of medical students on the issues of preserving and strengthening the health of the individual, the formation of a healthy lifestyle.


