Vol 69, No 4 (1988)
Organizational and managerial aspects of strengthening the preventive orientation of Soviet health care
Abstract
The XXVII Congress of the CPSU outlined the strategic course of the development of our country. Its main feature is a policy of acceleration, which consists not only in increasing the rate of economic growth, but also in improving social relations, updating the forms and methods of work, overcoming inertia, further developing the creativity of the masses.
Comparative study of thyroid function in autoimmune thyroiditis and endemic goiter in goiter endemic conditions
Abstract
Disturbance of functional state of pituitary-thyroid system in autoimmune thyroiditis and endemic goiter in recent years is attracting more and more attention of researchers. However, in recent years we have not found any works on a comparative study of the thyroid gland function in these lesions in the Russian literature.
Peculiarities of the morphological constitution of diabetic patients
Abstract
The problem of the relationship between morphological constitution and certain diseases has long attracted the attention of researchers. Diabetes is an example of such a disease. It is known that the insulin-independent type of diabetes is predisposed to people with excessive fat deposition, but the type of morphological constitution is often not taken into account when analyzing these relationships. The latter reflects the hormonal background of an organism and allows to judge the endocrine status of an individual over a rather long period of time, to evaluate retrospectively the peculiarities of endocrine glands functioning. That is why the study of morphological constitution of patients with the most widespread endocrine pathology - diabetes mellitus - is of practical and theoretical interest in terms of the possible development of anthropometric markers of predisposition to diabetes and further specification of its pathogenesis.
Hypoglycemic states and coma in diabetes mellitus
Abstract
Hypoglycemic conditions are not so rare in the work of a practicing physician, primarily an emergency physician. Of particular importance are hypoglycemia in patients with diabetes mellitus, developing against the background of insulin therapy, less often - during treatment with sugar-lowering sulfonamide drugs (chlorpropamide, glibenclamide). Diagnostic errors and difficulties are observed in the emergency care setting. Hypoglycemic conditions associated with insulin therapy of diabetes occur in 35-55% of patients.
Changes in immune reactivity in patients with complicated forms of diabetes mellitus during hemosorption
Abstract
Currently, it can be considered established that diabetes mellitus is accompanied by significant changes in the immune system. However, the literature data characterizing them are not only ambiguous, but also contradictory. There are reports on the likely role of changes in humoral reactivity in the pathogenesis of a number of complications of diabetes mellitus. Previously, there were reports on the use of hemosorption in patients with generalized microangiopathies, but the impact of hemosorption on the immune system in patients with complicated forms of diabetes has not been studied.
Ultrasound examination of the liver and biliary tract in diabetic patients
Abstract
The prevalence of liver and biliary tract lesions in diabetes mellitus is quite high. According to various authors, the so-called diabetic hepatopathy develops in 60-80% of patients. Biliary tract diseases in diabetes and in the general population occur with equal frequency.
Treatment of purulent wounds in diabetic patients with low-frequency ultrasound combined with helium-neon laser
Abstract
Acute surgical infection in diabetes mellitus is still one of the difficult problems of practical medicine and requires more in-depth research.
The aim of this work was to determine the effectiveness of treatment of acute pyo-inflammatory diseases of soft tissues in diabetic patients with ultrasound treatment of wounds with low-frequency ultrasound and subsequent stimulation of reparative processes in them by radiation of low-intensity helium-neon-based laser.
Clinical significance of renal cytomembrane condition in pediatric diabetes mellitus
Abstract
Renal failure associated with diabetic angionephropathy is the immediate cause of death in approximately 50% of patients with type I diabetes in childhood. It is important for the physician to identify preclinical signs of kidney damage, because the clinical symptoms of diabetic angioedema are indicative of the unfolding pattern of vascular complications.
Effect of hemocarboperfusion on renal function in diabetic patients with progressive nephromicroangiopathy
Abstract
Currently, in the treatment of some forms of chronic kidney disease and chronic renal failure is used method of intensive detoxification therapy - extracorporeal hemocarboperfusion (hemosorption). Of particular interest is the use of hemocarboperfusion in diabetic patients with diabetic nephromicroangiopathy, which is known to be one of the most serious complications of the underlying disease. Existing treatments (angioprotectors, disaggregants, anticoagulants, anabolic steroids, oxygenobarone therapy, hemodialysis) can not stop the progression of diabetic nephromycoangiopathy and are not effective in the development of chronic renal failure.
Criteria for Evaluation and Prediction of Hemodynamic Status and Physical Performance in Hypertension
Abstract
The aim of the present study was to develop criteria for quantitative assessment of the functional state of the circulatory apparatus and physical performance in hypertensive patients according to the indices of cardio- and hemodynamics without ergometric study. The necessity of this study was dictated by the following reasons: firstly, the average hemodynamic pressure increases as the disease progresses, and during physical activity its growth slightly outpaces the increase of heart rate. Secondly, reflecting peripheral vascular permeability, it determines postload and left ventricular myocardial tension. Thirdly, dissociation of proper and actual values of left ventricular isovolumic contraction period (with increasing actual) increases with disease progression. Fourthly, the formation of hypertrophy, disturbance of metabolic processes in myocardium, development of cardiosclerosis lead to prolongation of asynchronous myocardial contraction period, prolongation of which was found by many authors in different stages of hypertension.
Immunological parameters in young children with bronchial asthma and obstructive bronchitis
Abstract
Obstructive bronchitis and initial manifestations of atopic bronchial asthma are the most common causes of acute bronchial obstruction syndrome against the background of acute respiratory infections in early childhood, so it is very relevant to study the immunological mechanisms of these clinically very similar but different in genesis diseases.
Peculiarities of formation and course of pulmonary hypertension in patients with chronic obstructive bronchitis
Abstract
Chronic pulmonary heart is an obligate complication of chronic obstructive bronchitis, determines the clinic and treatment of the terminal stage of this disease, leads to early disability and in most cases - to death. Despite a considerable flow of information about this complication, some peculiarities of hemodynamics, in particular the formation of pulmonary hypertension in such patients, remain poorly studied and controversial, which was the reason for performing the present work.
Fibronectin content and cellular composition of peritoneal exudate in peritonitis
Abstract
Without denying the great importance of general body resistance in peritonitis, recently, many researchers tend to consider peritonitis as a kind of local inflammation with new pathogenetic and therapeutic concepts derived from this approach. It is known that the course and outcome of microbial inflammation are largely determined by the severity of local antimicrobial protection, which is primarily determined by antibacterial properties of the inflammatory exudate. Among the reactions of bacteria neutralization, the leading role is assigned to phagocytosis, which occurs with the participation of neutrophils and macrophages. The efficiency of phagocytosis, in turn, depends, first, on the number and quality (i.e., functional state) of the phagocytic cells and, second, on the activity of humoral factors of phagocytosis, called opsonins.
Medical tactics for combined craniocerebral trauma
Abstract
We summarized our experience in providing care to patients with closed craniocerebral trauma combined with closed skeletal bone injuries in a multidisciplinary city hospital. From 1975 till 1987 1051 patients with such trauma were treated at the neurosurgical department of the hospital, that was 6.3% of all the patients with craniocerebral injuries admitted to the hospital during the stated period. These included 78 (7.4%) children, 276 (26.3%) women and 697 (66.3%) men. There were 84% of the patients between the ages of 20 and 60. Road traffic injuries accounted for 54% of the causes of injury; alcohol intoxication accounted for 34.8% of the patients.
Leukocyte intoxication index of peritoneal exudate as a diagnostic test of postoperative peritonitis
Abstract
The problem of diagnostics and treatment of postoperative peritonitis and various intra-abdominal purulent complications is still one of the most urgent problems of emergency surgery. The lethality from peritonitis reaches 20-40% [1, 4]. Difficulties of diagnosing postoperative peritonitis are due to the layering of symptoms of the complication on the manifestations of postoperative condition and intensive care [5, 7]. Therefore, postoperative peritonitis is diagnosed at a late stage, which leads to delayed reoperations, and ultimately, to increased mortality.
Distal resection of posterior tibial veins in postthrombotic disease
Abstract
Among the resections of recanalized deep veins, distal resection of the posterior tibial veins is the most common. A special role in the development of venous outflow decompensation in post-thrombotic disease belongs to the dysfunction of the muscular-venous "pump" of the lower leg. The degree of impairment of its drainage function correlates with the severity of trophic disorders of the lower limbs skin. Striving for maximal operative correction of the main functional "knots" of the muscular-venous "pump", one of which is the distal section of the posterior tibial veins, is justified.
Neuropsychiatric abnormalities in pulmonary tuberculosis patients and their correction during treatment
Abstract
We examined tuberculosis patients with the Minnesota Multiple Personality Inventory (MMPI) to determine whether this technique could be used by phthisiatricians untrained in psychiatry to assess personality features and detect psychiatric disorders in patients.
Using the MMPI, modified by L.N. Sobchik, 149 patients (146 men and 3 women) with pulmonary tuberculosis aged 20 to 59 years were examined. Results of the examination were interpreted according to 3 evaluation and 10 clinical scales. Quantitative data were converted to T-points, and the personality profile was determined on the basis of their graphic representation.
On the mixed form of pathology in chronic alcoholism and cervical osteochondrosis
Abstract
It is known that biological background influences the course of the disease, causing the appearance of complex, mixed forms of pathology. The system-structural analysis of alcoholic pathology highlights neurological aggravation as a significant predisposing factor for unfavorable development of alcoholism. In studies of alcoholism clinical features in patients with neurological aggravation, predominantly traumatic, less often vascular brain lesions are considered, and premorbid brain impairment is assessed summarily, without taking into account the topics of the existing lesions and correlation of alcoholism syndrome-taxis to them.
Treatment of acute sensorineural hearing loss of viral etiology
Abstract
Influenza and acute respiratory viral infections account for 21 to 37.4% of the total structure of acute sensorineural hearing loss as causative factors.
The mechanism of acute cochleitis development can be explained by characteristic viral lesions of small vessels and subsequent pathological anatomical changes in the inner ear tissues: increased permeability of the vascular wall, extravasation and edema, which cause increased intralabyrinthine pressure, intraocular conduction disorders and acute receptor hypoxia.
Disorders in the system of nonspecific resistance in diabetic patients and their pharmacological correction
Abstract
Complications of infectious and inflammatory nature in patients with diabetes mellitus often determine the prognosis of the disease. In their development, along with disturbed metabolic processes, a known role is played by changes in nonspecific protection and immunological reactivity mechanisms of the body. The study of the state of humoral and cellular immunity in diabetes mellitus is due to the fact that the accompanying infectious-inflammatory process is characterized by a more severe course and difficult to treat.
Erythrocyte membrane permeability in diabetic patients
Abstract
The state of cellular homeostasis in diabetic patients was assessed by the permeability of erythrocyte membranes, which can serve as an indicator of functional disorders of the vascular wall. It was found that the value of cytoplasmic membrane permeability depends largely on the variations in the ratio of cholesterol and phospholipids. An absolute or relative increase in membrane cholesterol content is accompanied by stabilization of cellular structures, which, in turn, leads to a decrease in permeability to non-electrolytes and ions and changes in the activity of membrane-bound enzymes.
Predian in the complex treatment of patients with diabetes mellitus
Abstract
The aim of this work was to study the effectiveness of predian (sulfonamide developed at the Research Institute Servier, France) as a sugar-lowering agent, as well as its effect on the coagulation and antiplatelet systems of diabetic patients.
Functional state of the pineal gland in women of reproductive age
Abstract
The frequency of calcification of the pineal gland is 3% in the first 12 months of life, gradually increasing to 7.1% in children 10 years of age and reaching 33% in 18-year-olds. In adults, calcification of the pineal gland is found in 50-70% of those examined.
Electrocardiographic determination of necrosis focus size and the rate of its formation in the acute period of myocardial infarction
Abstract
We examined 54 patients with acute myocardial infarction who were admitted to the clinic during the first 6-10 hours after the onset of the pain attack. There were 31 men and 23 women. 7 patients were aged 30 to 50 years, 35 patients were aged 51 to 70 years, 12 patients were older than 70 years. According to ECG data, the focus of necrosis in all patients was localized in the anteroposterior region. The results of these patients without atrioventricular conduction abnormalities and acute postinfarction aneurysms of the left ventricle are presented in the article.
Treatment of peptic ulcer of the stomach and duodenum with helium laser
Abstract
We treated 160 patients (141 men and 19 women, the age of patients was from 18 to 67 years) with gastric and duodenal ulcers using a helium-neon laser LG-75 with an output power range from 15 to 35 mW. Laser radiation was injected into a quartz monofilament 4 mm in diameter and 3 m in length using a transient focusing device. The power of radiation at the output of the fiber was 85% of the initial one. In 127 patients the ulcer (size - 0,8±0,2 cm) was localized in the bulb of duodenum, in 33 patients - in the stomach (0,7±0,1 cm). The efficacy of treatment was judged by the dynamics of clinical, radiological, endoscopic and morphological parameters. Acid-producing function of the stomach was investigated by intragastric pH-metry, motor function - by electro gastrography. The therapeutic manipulations were performed daily or every other day for 5 min at a power density at the end of the glass fiber of 1.5-2X103 wt-m-2. In all cases laser therapy was started after histological and cytological examination of biopsy material.
Experience of polymeric film application for abdominal cavity drainage
Abstract
In the Emergency Surgery Clinic of Kazan Emergency Medical Care Hospital since July 1986, for drainage of abdominal cavity after operations for various purulent processes, drains prepared from 10-50 microns thick elastic hydratecellulose film are used. A sheet of film is folded in the form of an accordion into a package with a rib width of 0.5-1 cm and a length of 10-30 cm; such a package usually has 10-15 planes. The draining effect of the hydrate cellulose film drainage is maintained throughout its stay in the abdominal cavity. However, such drainage also has certain disadvantages.
On the colonic mucosal barrier in patients with nonspecific ulcerative colitis
Abstract
Despite numerous studies, the etiology and pathonemesis of nonspecific ulcerative colitis have not yet been definitively elucidated. The main hypothesis explaining the occurrence of this disease is considered to be immunological. However, it has been repeatedly suggested that the state of protective mucosal barrier plays a certain role in its pathogenesis.
Paraproctitis due to foreign bodies of rectum
Abstract
Our experience of treatment of more than 4000 patients with acute paraproctitis testifies that rectal foreign bodies as a cause of pararectal abscesses occur in 0.6-0.8% of cases. Gradual onset of purulent complication should be noted from the peculiarities of course and clinical picture. During the first 1-2 days the patients felt discomfort and burning in the anus area and then purulent process with local and general manifestations developed.
Toward an explanation of the clinical effect when using industrial albumin preparations
Abstract
Currently, in clinical medicine, preparations of donor and placental albumin are widely used, which are highly effective therapeutic agents for many pathological conditions. It is believed that placental albumin by its physico-chemical properties and physiological effect does not differ from donor albumin, but there are good reasons to doubt this statement.
Treatment of victims with closed diaphyseal fractures of the femur in combination with craniocerebral trauma
Abstract
The present report is based on observations of 103 victims with closed fractures of the diaphysis of the femur combined with craniocerebral trauma. There were 89 men and 14 women. Compression of the brain by intracranial hematoma was diagnosed in 2 persons. Industrial injuries were registered in 16.5% of the victims, road traffic injuries in 69.9%, household injuries in 13.6%. In a state of alcoholic intoxication 23.3% of the victims were injured. In the state of traumatic shock 37.8% of the patients were admitted.
The state of antitumor resistance in uterine myoma patients
Abstract
We studied the state of antitumor resistance in patients with uterine myoma. Specific immune defense was assessed by the relative and absolute numbers of T-lymphocytes in peripheral blood, the ratio of subpopulations of T-helpers, T-helpers and T-suppressors, delayed-type hypersensitivity reactions with 2,4-dinitrochlorobenzene (DNCHB) and inhibition of leukocyte migration. Non-specific resistance was investigated by the activity of complement and its third fraction, as well as daily excretion of 17-OX. In order to clarify the state of the pituitary-adrenal system, dexamethasone suppression test was performed by determining the excretion of 17-OX after a two-day administration of the drug at a dose of 0.125 mg 4 times a day.
Clinic and treatment of tetanus in adults
Abstract
Against the background of constant immunization of the population against tetanus, the incidence of this infection has decreased, but the mortality rate remains high.
We analyzed 13 case histories of tetanus patients. In all cases the disease was generalized. Among the patients there were 9 men; 10 patients were rural residents. The age of the patients ranged from 21 to 47 years, indicating their insufficient prophylactic immunization. The disease was more often observed in April-October, i.e. during the agricultural season.
Treatment of patients with paranoid schizophrenia with depressive states
Abstract
In the treatment of schizophrenic patients with complex depressive-paranoid states, various combinations of neuroleptics and antidepressants are widespread, but the tactics of their use have not yet been sufficiently developed.
We compared the regression of psychopathological symptoms and the results of therapy in three clinically homogeneous groups of schizophrenia patients with different order of administration of thymoneurolepsy components.
Abscesses of epiglottis, lingual tonsils and acute subclavian laryngitis with the development of acute laryngeal stenosis
Abstract
Simultaneous combination of abscesses of epiglottis, lingual tonsils and acute subclavian laryngitis with the development of acute laryngeal stenosis in elderly patients against the background of respiratory-viral disease is extremely rare. We present our own observation, which is of undoubted interest for otolaryngologists.
Immunotherapy with bacterial allergens in patients with chronic pyodermitis
Abstract
The aim of this work was to study the allergic-immunological status of patients with chronic pyodermitis and the effect of specific immunotherapy with bacterial allergens on it.
Allergological examination of patients was performed by skin testing with allergens of Staphylococcus aureus, Streptococcus pyogenes and Escherichia coli. New bacterial allergens developed at the Kazan Research Institute of Epidemiology and Microbiology, purified from immunologically inert ballast by column gelfiltration on Sephadex G-50, were used for the tests.
A life shackled by disease
Abstract
A young healthy person sees life as a long, promising road that he walks in search of his place in family, work, and society. He knows that there are serious and life-threatening illnesses that are difficult or even impossible to live with. From popular science or health education books and articles he has learned a rudimentary knowledge of the presence and prevalence of serious diseases that plague the civilized world. However, the fullness of life, the daily troubles and joys have their effect in the sense that one, except for personal professional interests, does not think more deeply about the world of the sick. One can only wish that one's journey through life will not be overshadowed by illness and that life, uncomplicated by illness, will pass according to expectation, ending many years later in physiological old age.
Sanitary and epidemiological analysis of the decrease in the incidence of typhoid fever in the Tatar ASSR during 30 years (1955-1985)
Abstract
From 1955 to 1985 in both urban and rural settlements of the Tatar ASSR there were positive changes in the sanitary conditions of the population: improvement of the sanitary condition of water supply sources, increase in the number of water pipes (see figure), reduction of the share of decentralized water supply sources, improvement of laboratory control of water supply sources and drinking water, and increase in water consumption of the population.
Epidemiological features of diphyllobothriosis in the Tatar ASSR
Abstract
The first report on cases of diphyllobothriosis in the Volga River basin was published back in 1862. Yu. Knoch reported about detection of this disease in Kazan, and in 1896 Professor A.E. Brehm wrote that broad lepidoptera was a "common guest" of Kazan gubernia inhabitants. For a long time, in most areas of the Volga River basin the infestation of the population with diphyllobothriosis was at a low level. Intense centers of diphyllobotrysosis began to appear in 1955-1965 in many regions and autonomous republics located in the Volga basin after creating the cascade of reservoirs: Rybinsk, Gorky, Kuibyshev, Volgograd, etc.
Study of natural focal diseases in island and shallow water ecosystems of Tataria reservoirs
Abstract
Creation of Kuibyshev and Nizhnekamsk reservoirs radically changed the structure and functional activity of historically developed ecosystems of former floodplains of Volga and Kama rivers. Due to the abrupt change of hydrological regime, there were significant disturbances in parasitocenosis of some natural focal infections and invasions, epidemiological significance of which in the regional pathology of the republic's population was quite pronounced. Thus, flooding of typical habitats of water vole (floodplain lakes, marshes) led to a significant reduction in the number of the species in reservoirs and thereby weakened epizootic tension of natural foci of floodplain type tularemia.
Modified method for determining skin capillary resistance
Abstract
Study of skin capillary resistance is of great importance when the reactivity of the body is changed under the influence of various physical and chemical factors. In this case predisposing factors may be a lack of UV radiation, lack of ascorbic acid and vitamin P in the body.
Grigory Ivanovich Sokolsky - the founder of Russian phthisiology
Abstract
Modern historians of medicine consider G.I. Sokolsky (1807-1886) an outstanding clinician, and regard his activity as "an important stage in the development of the national clinic, which combined the achievements of predecessors and laid the foundation for its future flowering".
Chronicle. Vol. 69, No. 4 (1988)
Abstract
For services in the field of public health and achievements in medical and preventive work was awarded the honorary title of honored doctor of the RSFSR Sitdykov Eduard Nazipovich - head of the department of Kurashov Kazan Medical Institute.