Vol 69, No 3 (1988)

We summarized the experience of treatment in the Republican Burn Center from 1970 to 1986. 1847 children with fresh burns at the age of 7 days to 14 years and 368 children with scar contractures and deformities after burns. The overall lethality in thermal trauma in children was 4.9%; in patients with deep burns it was 9.2%, which was determined to a large extent by the severity of the condition of the victims. The proportion of children with deep skin lesions was rather high, 53.2% of all hospitalized patients, with 522 patients having areas of deep burns within 10% of body surface, 225 patients had areas from 11 to 20%, 132 had areas from 21 to 30%, 66 had areas from 31 to 40%, 38 had areas from 41 to 50%, 19 had areas from 51 to 60%, and 11 had areas over 60% of body surface.

To diagnose periodontal disease and assess the effectiveness of treatment such methods of examination as X-ray diagnosis and reoparodontography are used. Of particular value is X-ray diagnosis, which allows to objectively determine the condition of the alveolar appendix bone tissue and the body of the jaw. Reoparodontography is very informative in the diagnosis of periodontal diseases in children, as it provides an opportunity to record the sprinkles for a long time and continuously without disturbing the physiological conditions of the studied area.

We analyzed 220 observations of complicated forms of acute appendicitis in children and medical histories of 22 patients who died of the disease. The causes of the adverse course of acute appendicitis were studied at three stages of medical care: 1) at the level of pediatric areas, ambulance services, and somatic pediatric departments, 2) in the general surgical departments of the CDC, and 3) in specialized pediatric surgical departments.

Transfemoral phlebography with renal and testicular vein catheterization is now widely recommended to elucidate the causes of varicocele, especially in recurrent disease. However, this method is available only in medical institutions with vasographic rooms, and varicocele cannot be classified as a rare disease because it is diagnosed in 8-20% of young men and in 8.4% of 10-15 year old boys. The association of fertility with varicose veins of the spermatic cord makes varicocele a social problem.

In recent years, our country has devoted considerable attention to the study of food allergies in children, which in many respects remains understudied; in particular, ways to improve the effectiveness of specific treatment are being sought. Attempts to use specific hypersensitization with food allergens in children and adults by oral, inhalation, subcutaneous and rectal methods have not yielded the desired results. The sublingual method, successfully tested for the first time on several adult patients, proved to be more promising. The efficacy of this method used in children with food allergies was 70-80%.

Rickets-like diseases are inherited metabolic disorders. The most common forms of these diseases are vitamin-E-dependent rickets, Debret de Tony-Fanconi disease, and vitamin-D-resistant rickets. Their differential diagnosis is still very difficult because the clinical and radiological picture of these forms is very similar. All forms of rickets-like diseases are characterized by significant metabolic disorders and primarily phosphorus-calcium metabolism. A large role in metabolic processes in the body plays magnesium as an activator of many enzymes, in particular alkaline phosphatase and pyrophosphatase, directly related to the process of mineralization of bone tissue. A number of authors note the close relationship of magnesium metabolism with phosphorus-calcium metabolism. However, magnesium metabolism in rickets-like diseases has been insufficiently studied; the magnesium level in the blood was determined only in individual patients.

Intensification of lipid peroxidation processes is of great importance in the violation of functional integrity of tissues of the respiratory tract and increased vascular and tissue permeability in a number of bronchopulmonary diseases. Since respiratory viruses are cytopathogenic agents, their leading role in the development of membrane disorders in acute inflammatory respiratory diseases in young children should be assumed. The works previously carried out in this direction refer only to the complicated forms of respiratory viral infections.

The immaturity of a number of functional systems in premature infants has a significant impact on adaptation to the conditions of extrauterine existence. First of all, it concerns the external respiratory system, which in premature infants has clear signs of immaturity. The body even of a preterm infant at birth is for some time under conditions of reduced gas exchange and moderate metabolic acidosis, but this period is short - gas exchange is quickly normalized.

The effect of impaired uterine contractile function on the course of pregnancy and labor in women with extragenital pathology was studied. A total of 147 women at 20-27, 28-36, 37-40, 41 weeks' gestation were examined. There were 79 (53.7%) primiparous women, of whom 5 (3.4%) were over 30 years of age. The medical history showed that pregnancy was terminated in 27 (18.4%), menstrual irregularities with algodysmenorrhea with premenstrual syndrome in 112 (76.2%), marked endocrine disorders in 12 (8.2%), vascular dystonia in 43 (29.2%), lipid metabolism disorders in 27 (18.4%), pyelonephritis in 69 (46.9%), anemia in 24 (16.3%). Pregnancy developed against a background of sexual infantilism in 92 (62.6%), hypoplastic uterus in 14 (9.5%).

Currently, there is a growing interest in the use of non-medicinal methods of treatment worldwide, in particular, laser reflexotherapy. This is due to the fact that not in all cases the prescription of medications leads to the desired therapeutic effect, there are often side effects when using them, the allergic predisposition to a variety of medications grows rapidly.

In recent years, the dependence of vascular disease on age and sex has been widely discussed in the literature. Disturbance of hormonal activity of endocrine glands plays an important role in the development of circulatory pathology.

Impaired autonomic nervous system function in diffuse neurodermatitis is now generally recognized, with the crucial importance believed to be not generalized, but local dystonia of both parts of the autonomic nervous system. Studies carried out in diffuse neurodermatitis have shown significant disturbances in catecholamine excretion. A decrease in urinary excretion of adrenaline and a marked increase in norepinephrine excretion were observed during the exacerbation period of the dermatosis. Despite many existing methods of treatment, therapy of patients with diffuse neurodermatitis is often a difficult task in the practice of a dermatologist.

Until recently, the main methods of surgical treatment of deep burns remain plasty with split skin grafts and skin and fat flaps on a temporary or permanent feeding stem (Indian, Italian, stalked, counter triangular flaps). The use of various modifications of dermatome plasty makes it possible to save the lives of many burned people doomed to death in the past. However, the disadvantages inherent in the above methods of dermatoplasty do not allow us to fully implement a saving and restorative approach in treating deep burns and their consequences, in particular burns of IV, IIIB degrees, localized in functionally active areas of the body, and deep burns with an area greater than 30% of the body surface.

Non-steroidal anti-inflammatory drugs (NSAIDs, phlogolytics, antiphlogistics) belong to the most frequently prescribed medications in world medical practice. In combination with other drugs or individually they are used to treat rheumatic diseases, inflammatory processes in a variety of pathologies. They are widely used to relieve pain, reduce elevated body temperature. That is why the questions of development of side effects of antiphlogistics manifested by affection of different organs and systems are of particular importance. In recent years, in the literature, the issue of the interdependence of the main (anti-inflammatory) and side effects of NSAIDs, which is a direct manifestation of their pharmacological effect, is widely discussed.

The processes of free-radical oxidation of lipids are considered to be the fundamental molecular mechanism of biological membrane damage. At the present stage, significant data have been accumulated on the activity of lipid peroxidation processes in acute pathology in children.

To assess diagnostic significance of enzyme activity in peripheral blood leukocytes when determining individual stages of acute purulent destructive pneumonia in children we performed cytochemical studies in 52 patients aged from one month to 10 years. In 14 children the disease was infiltrative, in 38 - destructive. The control group consisted of 15 healthy children of the same age.

Photometry of 6 radiographs of the thoracic spine of healthy children and adolescents aged 10 to 14 years was performed. Nine radiographs were obtained for one radiograph, for a total of 54. All photograms turned out to be identical. The data of X-ray photometric analysis showed that the optical density of the bone structures fixed in the photogram was relatively stable in each case. Asymmetry of optical density of bone structures was noted: it was higher on the left than on the right, especially at the level of D₆. The optical density of all bone structures was higher the lower the vertebra was located, i.e. the density of bone structures of the upper vertebra was lower than that of the lower vertebra, which could be explained by the overlaying of the mediastinal shadow on the left side, especially at the level of D_5-6-7-8. In all other cases, the asymmetry should be considered as a variant of the structure.

We examined 100 children aged 2 to 13 years with the initial stages of scoliosis. Eighty-eight of them (group 1) showed signs of natal pathology of the cervical spine and spinal cord, and 12 of them (group 2) showed signs of natal pathology of the lumbar spinal cord. In both groups, the frequency of unfavorable births in the obstetric history, as well as the lag in physical development of these children in the first year of life, were noteworthy.

From 1983 to 1986, we operated on 5 patients with pelvic osteomyelitis. There were 2 children aged 8 to 10 years and 3 patients aged 11 to 15 years. Duration of the disease in 3 patients - up to 14 days, in 2 - from 2 to 4 months. Three patients were diagnosed with acute hematogenous osteomyelitis and two with chronic osteomyelitis. The inflammatory process in all 5 children was localized in the right half of the pelvis, in 4 - in the iliac bone, in one - in the iliac, pubic, and sciatic bones with lesions of the hip joint.

Sulfhydryl groups were detected in the dry plasma of 63 first-born and 49 second-born healthy women at 38-40 weeks of pregnancy, during the first and second periods of labor, at 2 hours after delivery, and on the 3rd and 5th days after delivery. Ten healthy non-pregnant women of childbearing age constituted the control group.

We analyzed surgical outcomes in 235 women aged 50 to 81 years operated on for uterine fibroids, ovarian cystomas (49), endometrial cancer (30), uterine prolapse and vaginal wall prolapse (25), preinvasive cervical cancer combined with myoma and adenomatosis (3), uterine tube cancer (1).

Non-infectious diseases of the digestive organs are among the diseases whose prevalence has significantly increased in recent years both among adults and children. In order to study the prevalence of biliary diseases in children we carried out a study by the method of A. A. Baranov and O. V. Grinina in five towns and working settlements of the Udmurt ASSR. A total of 2249 children aged 7 to 14 years were examined.

In recent decades, in our country and abroad, chemical agents are widely used to protect crops and to control arthropod pests. The intensity of their use in agricultural zones of the country depends on the type of crops grown, natural-climatic and agrobiological conditions. Numerous hygienic studies proved that long-term and intensive use of chemicals in agriculture causes not only increase in their residual amounts in environmental objects, but also probability of toxic effects of pesticides on human and animal organisms. In areas with intensive use of pesticides, morbidity of children was 2.3-3.6 times higher.

It is known that uroflowmetry has significantly expanded the diagnostic capabilities of urological studies. There is no doubt about the need for widespread use of uroflowmetry in daily pediatric urological practice.

The congress heard and discussed the reports on women screening for the prevention of maternal and perinatal pathology, training and professional development of obstetricians and gynecologists; postpartum purulent-septic diseases, endometriosis and new methods of treatment in obstetrics and gynecology.

It is 60 years since his birth and more than 35 years of medical, pedagogical and social activities of Professor G. D. Ovrutsky, the Head of the Chair of Therapeutic Dentistry of Kazan Medical Institute named after S.V. Kurashov, Doctor of Medical Sciences, Professor.

The III All-Union Symposium on Immunology of Reproduction was held in Kiev on September 21-23, 1987. The main goal of the symposium was to bring together the results of basic and applied research on human and animal reproduction. Immunological bases of infertility in marriage, onset and prolongation of pregnancy, influence of various factors on fetal development and histocompatibility antigens of HLA system, significance of humoral and cellular factors in pregnancy and lactation pathology were discussed.