Vol 68, No 6 (1987)

Current Problems of Restructuring TASSR Health Care


On September 12, 1987, the project of the Central Committee of the Communist Party of the Soviet Union and the Council of Ministers of the USSR "The main directions of development of public health and restructuring of the USSR healthcare in the twelfth five-year period and for the period up to 2000" was discussed at the meeting of party-economic activists in Kazan. In our republic, as well as in the whole country, the discussion of the project of reconstruction of the healthcare system was held with great interest, since all the existing problems of healthcare are connected with the achievement of one ultimate goal - people's health.

Kazan medical journal. 1987;68(6):401-404
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Metabolic basis of burn intoxication and ways of detoxification therapy

Lifshitz R.I.


The pathogenesis of burn toxemia is one of the central problems of combustiology. Due to the successes of antishock therapy, burn mortality is currently observed mainly not in the state of shock, but in the periods of toxemia and septicotoxemia. There is an urgent need to study the pathogenesis of endogenous intoxication after thermal injuries and develop the most promising ways of detoxification therapy. Clearly, this requires the solution of a number of interrelated issues: clarification of the nature of pathochemical reactions in relation to the function of various organs and systems, their dependence on the area and depth of the lesion, the nature of the toxic products that determine the changes occurring, and finally, the appropriate ways of their inactivation or removal from the body. Most of the above questions have been studied for a number of years by the staff of the Biochemistry Department of Chelyabinsk Medical Institute and the Regional Burn Center, which is the clinical base of the department.

Kazan medical journal. 1987;68(6):405-407
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Surgical tactics for burn injuries

Salikhov I.A., Akhmerov A.B., Shafikov I.Z., Arslanov G.F.


Creation of optimal conditions for the fastest autoplastic closure of a burn wound in thermal lesions, as it is rightly emphasized in many works, is one of the main principles of treatment of the injured [2,3]. Thus, the goal is to minimize the adverse manifestations of burn disease, especially in the periods of toxemia and septic toxemia, to avoid a number of serious complications, to ensure faster and better wound healing without the development of deforming scars and contractures. After removing the patient from the state of shock in deep burns the important role belongs to timely necrectomy. With this tactic it is possible to clean the wound from necrotic tissues before purulent-demarcating inflammation develops in it and thus reduce the treatment period.

Kazan medical journal. 1987;68(6):408-409
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Organizational principles of medical rehabilitation of burned people

Azolov V.V., Dmitriev G.I.


Burn injury is a serious medical, social, and economic problem and has attracted a great deal of attention from surgeons and trauma surgeons. Advances made in the treatment of patients with deep and extensive burns over the past three decades have contributed to a reduction in mortality, but have led to an increase in the number of disabled persons. Most of the disabled are of active age, so their rehabilitation is essential for the restoration of the country's workforce. At the same time, the issues of rehabilitation of burned persons and treatment of postpartum scars require further study. A difficult problem is rehabilitation of patients who received burns in childhood, as well as those who suffered from post-burn hand deformities. Until now there are no generally accepted regulations for medical rehabilitation of patients with burns, its principles, objectives and methods have not been developed. There are different points of view on the timing of the beginning of the rehabilitation period.

Kazan medical journal. 1987;68(6):409-411
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Problems of frostbite treatment

Vikhriev V.S., Kichemasov S.K., Skvortsov Y.R.


The mechanism of pathological changes developing in tissues in frostbite is diverse and varies within a very wide range, not only in different forms of local lesions (from the action of dry cold, "trench" and "immersion" foot, contact frostbite), but also in different areas of the lesion in the same victim. Probably, the pathogenesis of frostbite in different climatic regions is also dissimilar.

Kazan medical journal. 1987;68(6):411-414
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Acute cold trauma

Panchenkov N.R.


Acute cold trauma, despite the increasing comfort of life and work, remains quite frequent not only in the northern and mountainous regions of our country, but also in the middle zone. The high rate of disability of those who suffered III-IV degree frostbite gives grounds to consider acute cold trauma as a problem not only of medical, but also of social and economic nature.

Kazan medical journal. 1987;68(6):414-418
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A unified way to assess the electrical axis displacement of the heart

Latypov A.G.


As new electrophysiological and clinical information about the heart becomes available, the importance of determining the spatial orientation of the electrical axis of the heart is increasing in practical medicine. Suffice it to mention that displacement of the electrical axis of the heart is one of the cardinal symptoms of partial blocks of the left Gis bundle. At the same time, the evaluation of the electrical axis, limited to its projection on the frontal plane, and the terminology of the axis deviation, established many years ago, do not reflect the new trends in electrocardiography and need to be adjusted accordingly.

Kazan medical journal. 1987;68(6):418-420
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Study of bronchial patency in smokers

Pyrgar D.P.


It is known that one of the main reasons contributing to the occurrence of chronic bronchitis and pulmonary emphysema is tobacco smoking. Since chronic nonspecific lung diseases have become one of the most common forms of pulmonary pathology, detection of early, preclinical manifestations of the disease is of great practical importance.

Kazan medical journal. 1987;68(6):420-421
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Complex psychotherapy for patients with bronchial asthma and chronic obstructive bronchitis

Salikhov I.G., Yulmeteva D.G., Zhilyaev A.G.


We have analyzed the effectiveness of psychotherapy for patients with bronchial asthma and chronic obstructive bronchitis in general hospital conditions.
There were 104 patients under observation. 70 patients (27 men and 43 women) at the age of 16-62 years formed the main group. Bronchial asthma was diagnosed in 42 patients, infection-dependent and mixed variants with a severe course, in 28 patients - chronic obstructive bronchitis. The basic disease lasted from 1,5 to 28 years and was complicated by pulmonary emphysema in 9 patients, respiratory failure of I-II degree in 58 patients; 9 persons became disabled.

Kazan medical journal. 1987;68(6):422-424
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Peculiarities of clinical course and complex therapy of peritonitis after infected abortions

Nagovitsyna A.I., Kornyaeva Z.S., Borozdina V.N., Kuznetsova A.S.


Infected abortions remain the main source of septic complications. Most authors point out the sterile course of peritonitis in gynecological patients and the difficulty of its diagnosis, which confirms the relevance of the issue under study.
1132 women with infected abortions were under observation, 26 of them (2.3%) were diagnosed with peritonitis. The average age of patients with peritonitis was 25,6 years. On the 2nd-3rd day after the intervention and the first signs of disease 17 patients were admitted, on the 5th-6th day - 8 patients. To terminate the pregnancy women injected vodka (6), rubber catheters (14), metal objects (2), and oral medications (4) into the uterine cavity. Uterine perforation due to the introduction of metal objects occurred in 2 patients.

Kazan medical journal. 1987;68(6):424-425
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Treatment of patients with open fractures of long tubular bones with a new external fixation device

Aidarov R.B.


The problem of treatment of patients with open metadiaphyseal fractures of long tubular bones is relevant due to the increasing frequency of these injuries and their particular severity.
From 1978 to 1983 there were 213 patients with open metadiaphyseal fractures of long tubular bones in the traumatology departments of the emergency hospital. There were 175 (82%) men and 38 (18%) women. The majority (72.7%) were persons of the most employable age, from 21 to 50 years old. There were 45 (21.4%) persons admitted under the influence of alcohol.

Kazan medical journal. 1987;68(6):426-429
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Treatment of posttraumatic osteomyelitis of long tubular bones

Khabirova G.F., Zakirov Y.A.


The treatment of osteomyelitis of the long tubular bones is a complex problem of traumatology and orthopedics, as well as of purulent surgery. The difficulties of its solution are associated with extensive bone lesions, which causes frequent relapses of this severe disease and leads patients to long-term disability, permanent disability, and frequent and often traumatic surgeries.

Kazan medical journal. 1987;68(6):429-432
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Chronic cerebral vascular insufficiency in childhood

Ratner A.Y.


Cerebral vascular disorders are one of the most frequent diseases of mankind. The literature devoted to this topical problem is extremely rich, but the leading place in it belongs to acute cerebral circulatory disorders, while in practice chronic cerebral vascular insufficiency is more common. This symptom complex is detected most often in elderly people, although in the last decade there are more and more publications about its detection at younger age.

Kazan medical journal. 1987;68(6):432-433
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Changes in color vision and visual field in patients with chronic alcoholism

Galiaskarova F.R.


It is well known, how important is the diagnostics of color vision and visual field disturbances during professional selection and military-medical expertise. Due to prevalence of alcoholism all over the world and its high frequency revealed in persons of working age the question about the state of color vision and visual field in patients with chronic alcoholism seems to be of a particular importance. There are only few reports in the literature about color perception disorders and visual field changes in such patients.

Kazan medical journal. 1987;68(6):434-435
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Modern principles of burn treatment

Pakhomov S.P.


According to the World Health Organization, burns are the third most common type of injury. Some progress has been made in the treatment of burn victims, but extensive deep burns result in high mortality.
The course and outcome of burn injuries largely depend on the timeliness of first aid and rational treatment throughout the disease. With burns over 10% of the body surface (in young children - 5%) there is a real danger of shock. Therefore, when providing first aid, measures aimed at preventing shock and infection in the wound are necessary. To this end, anesthetics are administered (50% solution of analgin with 1% solution of Dimedrol). If the epidermis is preserved, it is advisable to cool the burned surface immediately with a stream of cold water or other available means, and a sterile dressing should be applied to the wound. When burns are localized on the extremities with involvement of functionally active areas, transport immobilization is indicated. All burn victims are evacuated to a surgical hospital.

Kazan medical journal. 1987;68(6):436-438
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Treatment of idiopathic osteonecrosis of the femoral head

Prokhorov V.P.


Idiopathic osteonecrosis of the femoral head in adults is one of the most common degenerative-dystrophic diseases of the hip joint, with a clear upward trend. Affecting individuals of relatively young age, with especially frequent bilateral development (up to 50% of cases), this pathology leads the most able-bodied patients to severe and irreversible disability. Therefore, the nature of idiopathic osteonecrosis and its treatment remain among the most pressing problems in modern orthopedics and in clinical medicine in general.

Kazan medical journal. 1987;68(6):439-442
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Radiation damage to the intestines

Volodina G.I., Abdulkhakova D.A.


Recently, radiation therapy has become increasingly important in the treatment of cervical cancer. Approximately 80-90% of patients are prescribed combined or combined treatments. Technical improvement of equipment, the use of fractional fractionation, intracavitary and distant irradiation, and supervoltage therapy have improved immediate and long-term treatment outcomes. However, the increase of focal total doses in the primary tumor area is often accompanied by the development of different types and severity of radiation reactions and damage of organs adjacent to the uterus, among which radiation reactions and intestinal damage dominate. They occur when the intestine is irradiated with doses higher than tolerated (for small intestine - 35 gray, for large intestine - 40-50 gray), and are caused primarily by high sensitivity of intestinal mucosa to the effects of ionizing radiation. Frequency of radiation injuries of the intestine is in direct dependence on the total absorbed doses of ionizing radiation and on the method of radiation therapy.

Kazan medical journal. 1987;68(6):442-445
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The use of crystalloids in the treatment of burn shock in children

Zakharov S.V., Ivanov G.A., Petrov F.S.


Burn shock is manifested by acute hypoxia due to hypovolemia and microcirculatory disorders. When treating burn shock, we aim to relieve tissue hypoxia by replenishing the volume of circulating blood and improving microcirculation by administering crystalloids.

Kazan medical journal. 1987;68(6):445-446
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Influence of some chemicals on central and cerebral hemodynamic indices

Goncharova L.N., Krugly V.M., Skvortsov Y.I.


The aim of the study was to investigate the effect of unsaturated and unsaturated hydrocarbons and acrylonitrile on the indicators of central and cerebral hemodynamics and physical work capacity of workers of different seniority groups.

Kazan medical journal. 1987;68(6):446-446
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Peculiarities of the course of Goodpasture's syndrome

Andreev V.M., Saitova R.A., Popov I.P., Nizamutdinov E.Z.


Goodpasture's syndrome (segmental necrotic glomerulitis with hemorrhagic alveolitis; pulmonary hemosiderosis with nephritis, hemorrhagic pulmonary syndrome, pulmonary purpura and nephritis, etc.) is a rare symptomcomplex characterized by a combination of severe kidney and lung damage in the form of hemorrhagic alveolitis (pulmonitis) and nephritis.

Kazan medical journal. 1987;68(6):447-448
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Outpatient treatment of brachial scapular periarthritis with hydrocortisone combined with hypothermia

Ilyinsky I.S., Bekmachev V.I.


Periarthritis of the shoulder-blade arises as a reactive inflammatory process after trauma or from primary inflammation of the joint pouch. The treatment of this disease is a difficult task. Conservative methods are not always effective, and surgical methods are not widespread. Some authors have achieved success with hydrocortisone injections.

Kazan medical journal. 1987;68(6):448-448
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Improvement of treatment of diaphyseal fractures of the tibia bones

Kovalenko N.A.


Since 1984 we use a modification of compression-distraction osteosynthesis for treatment of patients with diaphyseal fractures of the tibia bones in the emergency hospital, which consists of the following. Under local intraosseous anesthesia we put two spokes through each fracture of the tibia in the frontal plane perpendicular to the tibia axis. Those spokes that are closer to the fracture plane have a thrust pad. The location of the stops corresponds to the nature of fracture displacement in the frontal plane. If there are no spokes with stops, you can use spokes previously knotted on the ring of the Ilizarov apparatus with the help of a spica tensor. The spokes are as far apart as possible (within the length of the fracture). They are fixed and tensioned in the semicircles of the Ilizarov apparatus with special screws with a longitudinally located channel in the center for a spoke or with an adapted spicenator from the Gudushauri, Volkov-Oganesian apparatus. For repositioning of fragments in the sagittal plane we use brackets with rods located perpendicular to the tibial axis, which allow displacement of fragments relative to each other.

Kazan medical journal. 1987;68(6):448-449
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Preterm abdominal pregnancy

Sabirov F.M.


Here is a case of abdominal pregnancy of practical interest.

Ch., 33 years old, was admitted on 29.10.1984. She underwent appendectomy and tubectomy for right ectopic pregnancy in 1979.

Menstruation from the age of 17 years, every 4 weeks for 7 days. Sexual intercourse since the age of 22. There were two spontaneous abortions and an ectopic pregnancy. My last menstruation was on 21.01.84. I was admitted to the 2nd maternity hospital on 26.10.84.

Kazan medical journal. 1987;68(6):449-450
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Structure of congenital malformations in newborns

Belogorskaya E.V., Alexandrova L.Y., Urazaev R.A.


The case histories of 71 newborns with congenital malformations were analyzed according to the materials of the Children's Clinical Hospital for 1984-1985.
In the morbidity structure of newborns, children with developmental abnormalities accounted for 3.1% in 1984. In 1985, the figure was 6.6% (43 of 655 patients). Newborns with congenital malformations were hospitalized for acute respiratory diseases and pneumonia (53) and for natal trauma of the central nervous system (18). 80% of the children were admitted to the hospital directly from maternity hospitals, predominantly in the 2nd week of life, and 20% were admitted from the pediatric area. There were 58 preterm infants and 13 premature infants (30 girls and 41 boys).

Kazan medical journal. 1987;68(6):450-451
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Determination of tolerance intraocular pressure for diagnosis and choice of treatment tactics in glaucoma patients

Shamsutdinova R.A., Khasanova N.K., Semenova A.S., Galiaskarova F.R.


Often in practice, there are cases when the patient's visual functions deteriorate (decreased visual acuity, narrowed visual field) with seemingly normal intraocular pressure. Such patients usually undergo daily and even hourly tonometry in order to reveal the intraocular pressure elevations at different times of the day. But these studies do not always reveal a higher than normal increase in intraocular pressure.

Kazan medical journal. 1987;68(6):451-452
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Headaches with temporomandibular joint dysfunction

Nasibullin G.G., Zizevskiy S.A.


Headache as a concomitant symptom in functional diseases of the temporomandibular joint, combined with pain in the joint and masticatory muscles, is quite common. Our clinical observations also indicate a combination of temporomandibular joint dysfunction with headaches.

Kazan medical journal. 1987;68(6):452-453
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Effect of ultrasound on the functional state of the kidneys in the treatment of chronic dysmetabolic pyelonephritis in children

Solovyova N.A.


We studied the effect of ultrasound on the functional state of the kidneys, dysmetabolic disorders, membranolysis processes in the treatment of chronic pyelonephritis in children. We examined 27 children aged from 5 to 14 years old with chronic secondary dysmetabolic pyelonephritis caused by hyperoxaluria in combination with hypercalciuria in the active phase of the process. The functional state of the kidneys was determined by glomerular filtration, calcium and phosphorus excretion, ammonia and titratable acidity. The nature and degree of dysmetabolic disorders were assessed by urinary excretion of oxalate, calcium, uric acid. Membranolysis processes were judged by urinary excretion of ethanolamine and diene conjugates.

Kazan medical journal. 1987;68(6):453-453
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Psychotherapy of patients with alcoholism

Klassen I.A.


In recent years, biological methods and psychotherapy have been more widely used in the treatment of patients with chronic alcoholism. The search for new methods of treatment is explained, on the one hand, by the urgency of the problem of chronic alcoholism therapy in narcology, and on the other hand, by decrease of therapeutic efficiency of traditional sensitizing methods of treatment. In this regard, psychotherapeutic methods are increasingly being used since it is with their help that patients with alcoholism can overcome such phenomenon as anosognosia and then develop the desire to completely abstain from alcohol. At present in the domestic practice of psychotherapy for patients with chronic alcoholism there is a tendency to use a complex of methods with an emphasis on group forms of work. Attempts are made to combine collective methods of psychotherapy, which have the advantage of mutual influence of patients on each other, with the most individualized approach and coverage of each member of the psychotherapeutic group, based on personal properties of the patient's premorbid, properties of the disease development of personality, features of the patient's microsocial environment, personal value orientations.

Kazan medical journal. 1987;68(6):453-457
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Victor Alekseevich Perimov. Pages of life

Petrova R.G.


Lenin attached great importance to the formation of workers' historical consciousness, patriotism, and proletarian internationalism. The comprehension of modernity is inconceivable without reference to the revolutionary traditions, the people whose lives were given to the people. Gathering of Kazan University students on 4 (16) December 1887, where Lenin and other young men first stepped onto the path of revolutionary struggle, is an unforgettable page of history.

Kazan medical journal. 1987;68(6):457-459
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On the History of the Use of Instruments and Phantom in the Teaching of Obstetrics at Kazan University

Kozlov L.A., Sharafutdinov R.M., Knyazev A.A.


Nowadays, every obstetrics trainee must take a phantom course. Practical sessions to practice various diagnostic and therapeutic and surgical manipulations on the mock-up are no substitute for thinking about obstetrical situations and mastering surgical techniques.

Kazan medical journal. 1987;68(6):460-460
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Readers about the restructuring of the "Kazan Medical Journal"

Fatkullin F.K.


If we briefly formulate the credo of the Kazan Medical Journal, it is encapsulated in its subtitle: a scientific and practical journal for physicians. Orientation to the practicing physician, a generalist is a traditional feature of the journal since the renewal of its publication in 1921 and up to the present day. The journal's content is determined primarily by the needs of health care; its main reader and correspondent is the attending or sanitary doctor, who carries out the daily care of the health of Soviet people.

Kazan medical journal. 1987;68(6):461-463
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G. N. Drannik, Ya. M. Yena, T. V. Varetskaya. Products of fibrin/fibrinogen cleavage in pathological processes (biochemical and clinical aspects). Kiev, Zdorov'ya, 1987.

Zubairov D.M., Litvinov R.I.


One of the biochemical indicators objectively characterizing the state of hemostasis is the level of fibrin and fibrinogen cleavage products in blood, which are formed, as a rule, as a result of intravascular fibrin formation with simultaneous or subsequent activation of fibrinolytic system, accompanied by appearance of proteolytic enzyme plasmin. Plasmin splits (degrades) the formed fibrin or (to a lesser extent) fibrinogen, which leads to the appearance of more or less large protein "fragments" in the bloodstream, called products of fibrin degradation. Some of them are unable to clot and can be detected in serum after clot separation. Thus, the detection of fibrin degradation products always indicates intravascular activation of hemocoagulation and fibrinolysis systems.

Kazan medical journal. 1987;68(6):463-464
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G. N. Akzhigitov, M. A. Galeev, V. G. Sakhautdinov, Ya. B. Yudin. Osteomyelitis. M., Medicine, 1986.

Bogdanovich U.Y., Akberdina D.L.


The monograph, consisting of 5 chapters, is devoted to one of the most urgent problems of surgery - osteomyelitis.

Chapter I presents terminology and basic statistical data. The authors have proposed a new classification of osteomyelitis, which, in contrast to the generally accepted one, takes into account not only nosological forms, but also other important features of the disease. It is based on the principles of the International Classification of Diseases and consists of five headings (etiology, clinical form, stage and phases of osteomyelitis, localization and morphological signs, and complications). As it is more informative than those that have been accepted for guidance so far, the proposed classification deserves to be introduced into everyday practice.

Kazan medical journal. 1987;68(6):465-466
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Professor Zelig Nisonovich Blumstein

Zubairov D.M., Davydov V.S.


Honored Scientist of TASSR, Professor Zelig Nisonovich Blumstein passed away...
Z. N. Blumstein was born in 1894 in Sarapul of the former Vyatka province (now Udmurtian ASSR) in the petty bourgeois family. In 1911 he graduated from the Sarapul Real School and in the same year passed the examinations for the certificate of maturity in the 2nd Kazan Gymnasium. After graduation from the Real School he worked on the construction of the railroad as a draftsman, and then as an apprentice in a pharmacy. In 1913, he entered the Physics and Mathematics Department of Kazan University, where he studied three courses. In 1915, he transferred to the medical faculty of the same university, from which he graduated in 1924. While studying at the university, he earned his living by serving at different positions on the Kazan railroad.

Kazan medical journal. 1987;68(6):466-467
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Chronicle. Vol. 68, No. 6 (1987)


On 23.09.87 a press-conference was held for journalists of the Tatar Regional Committee of the Communist Party of the Soviet Union, where deputy ministers of health of the TASSR E. V. Karpukhin and D. S. Galeeva, pro-rector of the Medical Institute prof. H. H. Amirov, chief state sanitary doctor of the TASSR V. V. Morozov, chief doctor of the RKB S.V. Abuladze, head of the Kazan City Health Department R. I. Tuishev spoke.

Kazan medical journal. 1987;68(6):467-468
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