Vol 76, No 2 (1995)

LXXV years of the Kazan Institute for Advanced Training of Doctors


In solving the most important problems of protecting and strengthening the health of the population, postgraduate training of doctors plays an important role, which completes the process of the final formation of a specialist doctor. The main structures in the country that provide postgraduate training for doctors are state institutes and faculties for the improvement of doctors of medical universities, among which one of the leading places belongs to the Kazan GIDUV.

Kazan medical journal. 1995;76(2):81-84
pages 81-84 views

Theoretical and clinical medicine

Analysis of the variety of effects of the tranquilizer mebicar in experimental and clinical medicine

Zimakova I.E., Karpov A.M., Tagirova T.S., Salikhova R.R., Zhilyaev A.G.


The drug mebicar, which gave rise to a new class of chemicals with psychotropic activity - derivatives of bicyclic bisureas, has been experimentally studied for more than 20 years, and clinical experience with its use has been accumulating since 1979. During this short time on the scale of pharmacology, experimental substantiation and clinical confirmation of its effectiveness have been obtained in a number of ways. new indications in various fields of medicine: psychiatry, narcology, cardiology, anesthesiology, neuropathology, gynecology, gerontology, dentistry, sports medicine, etc. The versatility of the therapeutic effects of the drug has created a precedent that attracts the attention of specialists. The question arises about the fundamental possibility of such a variety of therapeutic activity of the drug and the mechanisms for its implementation.

Kazan medical journal. 1995;76(2):85-87
pages 85-87 views

Treatment of patients with subacute thyroiditis

Vagapova G.R., Nikishova T.V., Anchikov L.I.


The efficacy of local injection of glucocorticoids into thyroid gland tissue using the ultrasound or application method of dimethylsulfoxide with hydrocortisone and novocain is determined. The independent treatment methods proved to be effective in subacute thyroiditis of a slight form. In medium and grave forms of the disease the methods described arc a mean of the choice in combination with prednizolone in a maximum daily dose from 15 to 20 mg. The local treatment methods proposed reduce the number of the disease relapses, treatment terms and allow to decrease a maximum daily dose of prednizolone by a factor of 1,5—2.

Kazan medical journal. 1995;76(2):88-89
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Opisthorchiasis and pseudomphistomiasis in the Republic of Tatarstan

Khamidullin R.I., Fomina O.A., Sultanaeva E.G., Khamidullin I.R., Mingaleev A.A., Volchkova N.S., Klimova N.A.


On the vast territory of the Republic of Tatarstan, 4 large rivers of the European part of Russia flow: Volga, Kama, Belaya, Vyatka with their numerous tributaries. They are inhabited by an abundant flora of cyprinid fish species, which serve as a source of infection with opisthorchiasis, pseudomphistomiasis and metorchiasis. For the first time, opisthorchiasis in the republic was registered by us in 1957 (in Laishevsky, Kuibyshevsky, Rybno-Slobodsky, Alekseevsky, Kamsko-Ustyinsky, Yelabuga, Aktanyshsky, Zelenodolsky, Tetyushsky and Mamadyshsky districts).

Kazan medical journal. 1995;76(2):89-90
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Pathogenetic basis for the paravertebral novocainic block effect

Ibatullin I.A., Tarasco A.D.


In the course of experimental investigations as well as during the use of the paravertebral block in the combined therapy of patients it was established that the redistribution of the regional blood flow, the increase of the minute volume of blood in the system or in the affected organ, and the recovery of the microcirculation conditions, along with the changes of vegetative centers excitability are the pathogenetic basis for the paravertebral block effect. In the end this positive dynamics manifests itself in antiedematic and antiinflammatory effects of the paravertebral block as well as, probably, in the stimulation of reparation of tissue properties.

Kazan medical journal. 1995;76(2):93-96
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Peptic ulcer as a surgical problem

Kuznetsov V.A.


Peptic ulcer (PU) of the stomach (PU) and duodenum (DU) remains an urgent medical, biological and social problem today. In reality, there are relative and absolute increases in incidence. The relative increase is explained by improved diagnostics. According to the gastroenterological hospitals of Tatarstan, the number of endoscopically confirmed diagnoses of PU is almost 2 times higher than the number of clinical and radiological findings. The absolute growth is alarming, which is largely facilitated by the “social tension syndrome” as a companion of the political and economic crises.

Kazan medical journal. 1995;76(2):97-101
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Diagnosis and treatment of patients with chronic cor pulmonale

Andreev V.M.


Cor pulmonale refers to hypertrophy and (or) dilatation of the right ventricle due to diseases that affect the structure or function of the lungs, or both at the same time. Chronic cor pulmonale occurs with lesions of the bronchopulmonary system (chronic bronchitis, bronchial asthma, pulmonary emphysema, pulmonary tuberculosis, etc.), impaired mobility of the chest (kyphoscoliosis, Bechterew's disease, pleural folds, obesity, etc.) and diseases of the pulmonary artery system (repeated thromboembolism, primary pulmonary hypertension, lung resection, etc.). Right ventricular hypertrophy and insufficiency also occur with secondary changes in the lungs in patients with diseases of the left heart (cardiosclerosis of various etiologies, mitral stenosis) and congenital heart defects, but these cases do not apply to cor pulmonale. Most often, cor pulmonale develops in diseases of the bronchopulmonary system.

Kazan medical journal. 1995;76(2):105-108
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Endoscopic functional surgery of the nose and paranasal sinuses

Svatko L.G., Krasnozhen V.N., Batyrshin R.U., Budnik I.M., Latypov R.V.


In recent years, there has been a significant increase in the incidence of inflammatory diseases of the nose and paranasal sinuses, sinusogenic complications, and the transformation of the acute course of the disease into a chronic one [1]. The causes of this nature of changes in the incidence of sinusitis are considered to be polyetiological, the prevalence of influenza and acute respiratory diseases that does not decrease, the environmental burden on the upper respiratory tract due to air pollution, a decrease in the immunological properties of the body, and allergies [2].

Kazan medical journal. 1995;76(2):101-105
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Modern approach to the diagnosis and treatment of bronchial asthma

Fassakhov R.S.


Despite significant advances in diagnosis, as well as in the development and introduction into clinical practice of a wide range of new pharmacological drugs for the treatment of bronchial asthma, the incidence and mortality from this common lung pathology has been steadily increasing in recent decades. In developed countries, bronchial asthma affects up to 6% of the population; recent epidemiological studies conducted in Moscow revealed a comparable incidence rate [1].

Kazan medical journal. 1995;76(2):108-111
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Differential diagnosis of emergency conditions in patients with diabetes mellitus

Tsibulkin A.P., Anchikov L.I.


Diabetic ketoacidosis, severe diabetic hyperglycemic non-ketoacidemic hyperosmolarity, and hypoglycemia are the three most common acute complications of diabetes mellitus. They vary in severity and in advanced cases go into a coma. The effectiveness of treatment depends on the accuracy of diagnosis and the timeliness of its initiation.

Kazan medical journal. 1995;76(2):112-115
pages 112-115 views

Intensive care of obstetric bleeding

Kapelyushnik N.L., Zefirova T.P.


Bleeding in obstetric practice occurs in 5-15% of cases. They are observed during pregnancy, childbirth and in the postpartum period, accounting for 20-25% of the causes of maternal death.

Kazan medical journal. 1995;76(2):116-120
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Rickets in children

Maltsev S.V., Shakirova E.M.


Rickets in children is a common disease. Over the past decades, fundamentally new data on the metabolism and functions of vitamin D have been obtained, which has significantly changed the views on the etiology, pathogenesis of rickets, as well as methods for its prevention and treatment. It should be borne in mind that this is not only about insufficient intake of vitamin D in the child's body. An important role is played by internal mechanisms that predispose to the development of endogenous vitamin D deficiency and rickets. Due to the rapid growth and active processes of bone tissue restructuring in children of the first years of life and, especially, premature babies, there is a high need for vitamin D and phosphorus-calcium salts with the relative immaturity of the mechanisms that deliver these minerals to the bone and their assimilation. Exacerbations of rickets in children are associated with accelerated growth in the spring season, according to our data.

Kazan medical journal. 1995;76(2):120-124
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Principles of treatment of respiratory allergies in children

Potemkina A.M.


The problem of treating allergic diseases of the respiratory organs (respiratory allergosis - RA) remains difficult and far from being solved, as evidenced by their "rejuvenation": the onset of the disease at an early age, an increase in the prevalence and severity of the course, the frequent formation of forms resistant to basic therapy and frequent "fouling » complications in the form of side effects of sympathomimetics, corticosteroid hormones, drug allergies, which makes the treatment of children even more difficult. The change in the clinical course of RA is due to many reasons. These are general social factors (environmental imbalance, an increase in the range of allergens that affect, poor nutrition, etc.), and not always adequate therapy for patients. Patients, as a rule, are limited to symptomatic treatment aimed at stopping acute allergic symptoms, which gives a short-term effect and does not prevent their relapse; very rarely, specific therapy with etiologically significant allergens is used. At the same time, respiratory allergies, which in most cases occur in a chronic form, require the use of systematic complex and staged therapy, which ensures a long-term stable remission of the disease.

Kazan medical journal. 1995;76(2):124-129
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Diagnosis and treatment of dysfunctions of the temporomandibular joint

Nasibullin G.G., Zizevskiy S.A.


Diseases of the temporomandibular joint (TMJ) with functional disorders occupy a special place in the practice of orthopedic dentistry due to the complex clinic, morphology and function. Unlike other joints, the TMJ is devoid of the hyaline cover of the articular surfaces. The free capsule and the presence of ligaments allow the heads to perform various movements on different floors of the joint divided by the meniscus: sliding-translational in the upper section and articulated in the lower section. With some physiological movements, for example, when the mouth is opened wide, the articular heads come out of the articular fossae, resembling a dislocation on radiographs, which is actually a physiological subluxation.

Kazan medical journal. 1995;76(2):137-140
pages 137-140 views

Physiology of the neuromotor circuit of the respiratory system

Ivanichev G.A., Gainutdinov A.R.


This article is devoted to the neurophysiology of individual links of the neuromotor circuit of the respiratory system, which includes the respiratory muscles with the receptor apparatus, afferent pathways, spinal and suprasegmental centers of the respiratory muscles, as well as their efferent pathways. There are two types of mechanoreceptors in respiratory muscles: muscle and tendon spindles [2]. The main quantities measured by muscle receptors (spindles and tendon organs) are changes in length and tension that occur when a muscle is stretched and contracted.

Kazan medical journal. 1995;76(2):130-133
pages 130-133 views

To the problem of perinatal neuroradiology

Mikhailov M.K., Akberov R.F., Fattakhov V.V.


In the classification of childhood traumatism, birth traumatism is especially distinguished, which, according to the literature, ranges from 3 to 20–30% [10]. The proportion of birth injuries of the spine, spinal cord, and vertebral arteries is high [4, 5]. They are the cause of death of 10-33% of all dead newborns. It has been proven that during childbirth, the maximum mechanical and manipulation load falls on the cervical spine, spinal cord, and vertebral arteries passing in the narrow canals of the transverse processes [5].

Kazan medical journal. 1995;76(2):133-137
pages 133-137 views

Diagnosis and treatment of chronic inflammatory periodontal diseases

Khitrov V.Y., Zabolotny A.I., Khamidullina C.A.


Chronic inflammatory periodontal diseases - chronic catarrhal gingivitis and generalized periodontitis - have the largest share in the structure of periodontal tissue lesions. Starting imperceptibly, with mild superficial inflammatory phenomena, they lead to the destruction of the supporting apparatus of the teeth and to pronounced functional disorders of the dentition. In addition, focal activity of inflammatory periodontal pathology is high.

Kazan medical journal. 1995;76(2):141-145
pages 141-145 views

Assistance to the practicing physician

Tactics of relief and prevention of attacks of tachyarrhythmia

Arleevsky I.P., Andreichev N.A., Galeev A.A., Mikhailova A.H., Nasybullina R.S., Pak E.V., Rubanova E.F., Schultz Y.E.


The complexity of eliminating attacks of tachyarrhythmias (PTA) is due to their diversity, the difficulty of differential diagnosis and, finally, the individual response of the patient to the antiarrhythmic drug - a reaction that cannot be predicted. Currently, many different drugs are used to relieve PTA attacks, but the ideal remedy that can help with all heart rhythm disturbances without causing complications has not yet been created.

Kazan medical journal. 1995;76(2):145-149
pages 145-149 views

Emergency care for coma in diabetic patients

Anchikov L.I.


In diabetes mellitus, acute complications are possible in the form of diabetic ketoacidosis, hyperosmolar, non-ketotic, non-acidotic states of hypoglycemia, which can cause coma if patients are not provided with timely assistance. Treatment of patients with ketoacidotic coma, which is more common than other complications, includes the administration of rapid-acting insulin, fluid replacement, gastric drainage, electrolyte replacement, and management of comorbidities. With ketoacidosis, table number 9 is shown with fat restriction; once a day, sweet tea is allowed until the disappearance of acetone in the urine.

Kazan medical journal. 1995;76(2):149-152
pages 149-152 views

Treatment of diphtheria

Bashirova D.K., Shirinskaya A.I.


Diphtheria is an acute airborne bacterial infection caused by Corynebacterium diphteriae. It affects both children and adults and is manifested by an infectious-toxic syndrome, as well as fibrinous inflammation at the site of the pathogen, more often in the oropharynx.

Kazan medical journal. 1995;76(2):152-156
pages 152-156 views

Prevention of complications of pregnancy and childbirth in young women

Tukhvatullina L.M., Chechulina O.V.


Currently, despite the general trend towards a decrease in the birth rate in Russia among women of the main groups of childbearing age, there is an increase in the frequency of childbirth among young people. Teenage pregnancy, caused by early onset of sexual activity, poor awareness of contraceptive methods and their insufficient distribution, is a very serious problem in the field of gynecology [4].

Kazan medical journal. 1995;76(2):156-160
pages 156-160 views

Resuscitation of newborns born in asphyxia

Givolb I., Kuznetsova A.V., Mezhetdinova D.G., Abdullin I.M.


The most common cause of death in children in the first days of life is asphyxia (in 5-7% of newborns), which is preceded by intrauterine hypoxia (in 70-80 fetuses). Thus, a significant number of newborns require resuscitation.

Kazan medical journal. 1995;76(2):160-163
pages 160-163 views

New variants of the use of perosseous osteosynthesis in thetreatment of degenerative and dystrophic diseases of the hip joint in children

Gafarov H.Z., Akhtyamov I.F., Skvortsov A.P., Andreev P.S.


One of the most advanced directions in the development of the hip joint surgery and its complications is shown to be the use of external fixation apparatuses. The operative interventions system combining the classic elements, using the external fixation apparatuses, is developed taking into account the form of degenerative and dystrophic lesion of joints, the patient age and accompanying complications. Among all the destruction forms of proximal part of the femur in children the partial defect of epiphysis is most favourable in the subsequent prediction. The use of Elizarov’s apparatus not only makes easier the nursing and excludes the contracture in adjacent joints but fits the aims of the joint decompression, affected epiphysis unloading.

Kazan medical journal. 1995;76(2):164-169
pages 164-169 views

Social hygiene and healthcare management

Training of radiation diagnosticians at the departments of the Kazan Institute for Postgraduate Medical Education

Volodina G.I., Klyushkin i.V., Laryukova E.K., Mikhailov M.K.


Training of qualified radiation diagnosticians, their improvement is a complex and multifaceted task. Taking into account the peculiarities of the specialty, it is quite obvious that the successful training of personnel of radiation diagnosticians depends on the equipment of departments, basic medical institutions and on the high professionalism of the teaching staff.

Kazan medical journal. 1995;76(2):169-172
pages 169-172 views

Health insurance as an organizational and economic model of healthcare

Kiselev S.V., Tsalikova E.M.


The practice of forming budget allocations for health care, which was in force in the recent past, contributed to the fact that the share of health care expenditures in the total amount of budgetary funds was constantly declining. The principle of residual financing of such a socially significant industry as healthcare has become decisive. All these circumstances contributed to the formation of a number of negative trends, which manifested themselves quite clearly in the mid-80s with a shortage of medical personnel, hospital beds, medicines, a slowdown in the introduction of new medical technologies and modern medical equipment, etc. As a result, by the end of the 80s years, the quality indicators of public health protection in the country have sharply decreased.

Kazan medical journal. 1995;76(2):172-175
pages 172-175 views


Nosocomial staphylococcal infections and measures for their prevention

Grigoriev V.E.


In modern conditions, the problem of purulent-inflammatory diseases (PID) caused by opportunistic microorganisms is one of the most urgent in medical science and healthcare practice due to their wide distribution in medical institutions (HCIs) of any profile. The increasing importance of nosocomial infections in various countries is evidenced by the work of domestic and foreign authors. Thus, in different regions of the world, nosocomial HL are found in 5–17% of hospitalized patients [3]. In our country, they are especially often observed in obstetric and surgical departments, where their localized forms are a common cause of sepsis [2, 4].

Kazan medical journal. 1995;76(2):176-179
pages 176-179 views

Characteristics of the spread of diphtheria in the Mordovian SSR in 1983-1990

Chudov P.A., Khisamutdinov A.G., Grigoriev V.E.


The purpose of this report was to identify and generalize the main patterns of diphtheria epidemiology in the Mordovian Republic, which became more active in 1983-1990. against the background of a high level of antitoxic immunity in children. The materials for the study were maps of the epidemiological survey of foci, data from the republican, city (Saransk) and district TsGSEN on the epidemiological surveillance of diphtheria, including the results of observation of bacteriocarrier among the population and immunological control of children and adolescents.

Kazan medical journal. 1995;76(2):179-181
pages 179-181 views


Professor Tatyana Borisovna Tolpegina. Volume 76, No. 2 (1995)


December 25, 1994 marked the 70th anniversary of birth and 47 years of scientific, pedagogical and social activities of a prominent representative of the Kazan pathophysiological school, Honored Scientist of Tatarstan, Doctor of Medical Sciences, Professor Tatyana Borisovna Tolpegina. After graduating from the Kazan Medical Institute in 1947, T. B. Tolpegina completed her postgraduate studies at the Department of Pathological Physiology under prof. A. D. Ado and in 1952 defended her thesis on the topic "On the pathogenesis of bradycardia in typhoid fever." From 1954 to 1956, she was sent by the Ministry of Health of the USSR to work at the Mongolian University as the head of the Department of Physiology. The subsequent years of work as an assistant and associate professor at the Department of Pathophysiology of the Kazan Medical Institute ended in 1967 with the defense of a doctoral dissertation on the topic “Some mechanisms of an allergic reaction of the gallbladder”.

Kazan medical journal. 1995;76(2):182-182
pages 182-182 views

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