Vol 72, No 1 (1991)

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 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.