Vol 70, No 1 (1989)
Surgical care and ways to improve it in Tataria
Abstract
There are 75 medical preventive establishments, including RSB, RSB-2, DRKB, 11 city hospitals, 39 central republican hospitals, 2 regional, 14 district hospitals, 3 medical dispensaries, 3 dispensaries in TASSR.
The number of surgeons per 10 000 inhabitants in 1987 is 3,6 (2,95 in 1978), beds per 10 000 inhabitants - 18,9 (16,8 in 1978). There is an insufficient number of trauma care beds in TASSR: 2,6 (in RSFSR - 4,0), oncological - 1,8 (in RSFSR - 2,3), proctological - 0,4 (in RSFSR - 0,6). The average number of bed days in 1987 for surgical patients was 332 in urban hospitals, and 327 in rural ones.



Significance of risk factors for autonomic dysfunction in childhood and adolescence for physical examination
Abstract
Autonomic nervous system dysfunction is a common and extremely diverse clinical phenomenon. Most of these disorders are designated by the term "autonomic dysfunction", or "vegetovascular dystonia", which has no nosological independence. This universal syndrome of homeostasis shifts often manifests itself during critical periods of ontogenesis and serves as a signal of incomplete well-being. One of such periods is pubertal age, a time of intense growth and morphofunctional restructuring of the body. Functional disorders of autonomic regulation during puberty may be the initial, reversible stage of diseases of various organs and systems that arose in early childhood.



Prospects of reflexotherapy in the dispensary examination of neurological patients
Abstract
It is well known that the existing systems for the clinical examination of neurological patients have a number of disadvantages. The main ones are labor-intensive and cumbersome both diagnostic, including preventive examination, and therapeutic measures. The division of patients into the observation groups recommended by official guidelines allowed to put a significant emphasis on preventive treatment of patients with severe organic brain lesions, but this only partially solved the problem. A large part of the examinees, conventionally assigned to risk groups and practically healthy individuals, fall out of the neurologist's sight for a long time due to their workload both in the outpatient clinic and in the inpatient clinic.



Some New Opportunities in the Treatment of Patients with Atherosclerosis
Abstract
According to our deep conviction, measures to prevent, detect and treat atherosclerosis should be largely reoriented to the preclinical period of the disease and include correction, including non-medication, of metabolic disorders, elimination of other avoidable endogenous and exogenous risk factors for atherosclerosis, and primarily hyperlipidemia.



Surveillance and delivery tactics for women with brain tumors
Abstract
Pregnancy in women with brain tumors is extremely dangerous, and the maternal mortality rate is 24.3%. In 75% of cases, intracranial tumors develop in women of reproductive age and may first become apparent during pregnancy. This is due to fluid retention in pregnant women. We assume that tumor growth during pregnancy is associated with significant metabolic, particularly neuroendocrine changes in pregnant women; even the placenta as a powerful hormonal organ may be a stimulant, tumor growth.



The value of additional research methods in the diagnosis of cerebral infarction with a hemorrhagic component
Abstract
In the acute period of stroke, the study of cerebrospinal fluid composition and the results of one-dimensional echoencephaloscopy remain the most informative among the available additional methods. Some authors believe that in the absence of contraindications, analysis of cerebrospinal fluid should be performed in all patients, and refusal of the study should be considered a methodological error.



Scientific and organizational bases of mental health protection in production conditions
Abstract
The shifting interest of modern psychiatry to population and environmental studies is largely due to the preventive orientation of modern medicine, which sets as its main goal not the detection of early signs of disease, but the establishment of the state of health of the examinees and the prevention of the emergence and development of diseases. Among mental illnesses, borderline neuropsychiatric disorders, which account for up to 80% of all pathology, take first place. It is important that patients with borderline neuropsychiatric diseases rarely go to a psychiatrist on their own and do not receive timely skilled care from specialists, which leads to the aggravation of their condition and disability.



New tranquilizer Signopam in the complex treatment of prolonged neurosis
Abstract
Currently, there is a high incidence of neuroses in various countries. Patients with acute neuroses are successfully treated by therapists and neurologists. Qualified exclusion of somatic and other diseases that the patient suggests he has, convincing him of it, medication, including the use of tranquilizers, relieves the person of neurosis.



Hyperbaric oxygenation in the complex treatment of psychiatric disorders in inhalation toxicomania
Abstract
Recently, the problem of inhalation poisonings, observed as a rule, among children and adolescents who use substances used in household chemicals in order to achieve a euphoric state, has become increasingly important. Such substances have a selective toxic effect and cause tissue changes accompanied by organ and general hypoxia. This is the basis for the use of hyperbaric oxygenation, which has a powerful antihypoxic and disintoxicating effect as a means of pathogenetic therapy in this pathology, as well as psychoenergizing effect in various asthenic disorders.
The aim of the work is to find out the effect of hyperbaric oxygenation on the clinical course of acute period of intoxication in patients suffering from inhalation toxicomania.



Electromyographic analysis of motor units in patients with post-stroke hemiparesis
Abstract
Among the mechanisms of motor disorders in central motor neuron lesions, along with changes in descending impulses to motoneurons, segmental disorders are also assumed. In 1879, Charcot proposed the hypothesis of transsynaptic degeneration of motoneurons in lesions of central motor neurons. Subsequently, changes in motoneurons in experimental and clinical lesions of the pyramidal tract were observed by many, though not all researchers. Charcot's theory received as if a new confirmation in electromyographic studies, which showed a decrease in the number of motor units and increase in the territories of the preserved motor units in the muscles of the affected side in patients with hemiplegia.



Amplitude of head rotation in newborns in normal and pathology
Abstract
The problem of perinatal lesions of the nervous system is increasingly reflected in the literature. Particular attention is paid to birth trauma, and differentiation of brain and spinal cord lesions with an indication of the clinical syndrome found is becoming increasingly necessary. A larger problem is made up of smaller ones. Often, individual, even small symptoms can play an important role in the correct assessment of the neurological status. Our work is devoted to the study of one of such symptoms, not reflected in the literature.



Determination of the side of traumatic intracranial hematomas
Abstract
It is crucial for the neurosurgeon to recognize the side of intracranial hematoma formation in patients with craniocerebral trauma. This task is no less difficult than determining its presence. In addition to the neurological picture, the nature and localization of injuries to the scalp and skull bones should be taken into account. Meanwhile, such a traditional symptom of intracranial hematoma, as pupil dilation, occurs in 15-20% of patients on the side opposite the hematoma. Homolateral pyramidal syndrome is not uncommon (about 20% of the victims). The existing clinical dissociations are usually due to either severe concomitant contusion of the cerebral hemisphere opposite to the side with the hematoma or to the developed dislocation of the stem formations.



Clinic of cerebellar encephalitis in varicella
Abstract
According to the literature, the incidence of varicella in the nervous system is about 0.1-0.2%. Complications of the nervous system usually take the form of encephalitis and meningoencephalitis of viral-allergic nature. Based on 30 years of observations, we believe that cerebellar and vestibular disorders are most typical for chickenpox encephalitis; the same opinion is held by many authors.



Surgical treatment of tuberculous spondylitis in the TB Dispensary
Abstract
Treatment of tuberculous spondylitis in TB dispensaries remains a difficult task. Conservative treatment of spinal tuberculosis is effective only at the initial stage of the lesion. However, in recent years, focal forms of TB occur less frequently among newly diagnosed patients, and neglected and complicated forms of this disease, on the contrary, are more frequent, which is associated with diagnostic errors. In such cases, conservative treatment and antibacterial agents are ineffective; they are used only in the period of preoperative preparation and especially after surgery.



Development of babies delivered by cesarean section
Abstract
In order to prevent maternal and perinatal mortality, there has been a clear trend in the last decade to expand the indications for abdominal delivery. The frequency of cesarean section, according to different authors, ranges from 3-6.5 to 21.6%. At the same time, the immediate, short-term, and long-term results of cesarean section for a baby are insufficiently covered in the literature, and methodological approaches to nursing this group of children are not developed accordingly. Doctors often do not distinguish between abdominally and naturally delivered babies, and in some cases they consider cesarean section to be the optimal method of delivery for the fetus and the newborn. The first results of physiological studies of children born by cesarean section indicate that this operation is not indifferent to the newborn.



Laser reflexotherapy in the treatment of tobacco smoking
Abstract
Tobacco smoking is the most common substance abuse problem of our time and one of the causes of many serious diseases, especially in developed countries. According to WHO data, total death rate among smokers in different countries exceeds death rate among non-smokers by 30-80%, and the most significant part of smokers dies at the age of 45-54 years, which is especially valuable in terms of professional experience. Every year there is a growing danger of harmful influence of tobacco smoking on reproduction of population, deterioration of younger generation health. All this makes treatment of tobacco smoking very urgent task of medicine.



The importance of prognostic modeling based on the diagnosis of pre-pathology for the dispensary
Abstract
The presence of lowmanifest forms of diseases, steadily compensated pathological conditions, extreme environmental influences, negative influences of industrial and domestic conditions, heredity, bad habits cause the necessity to improve the health of almost every person. The purpose of the clinical examination is to detect early pathological changes which do not affect people's health for a long period of time and which, therefore, are not considered to be ill. The transition from health to disease is accompanied by the development of preclinical borderline conditions, referred to as prenosological.



First tone spectrum of myocardial infarction patients at rest and during exercise
Abstract
Spectral analysis is the most informative method of investigation of the heart sound symptomatology, which allows obtaining additional information about the state of cardiovascular system in patients with coronary heart disease.
The purpose of this work was to study changes in the frequency-amplitude composition of heart tones in response to dosed physical exercise and informativeness of these changes in patients with myocardial infarction of different severity of clinical course of the disease.



Treatment of hypertension depending on the effect of beta-adrenoblockers on blood serum lipids and lipoproteins
Abstract
Beta-adrenergic receptor blockers are widely used in the treatment of hypertension. However, in recent years, there have been reports of their adverse effects on lipid metabolism - an increase in triglycerides, to a lesser extent in cholesterol and low-density lipoproteins, a decrease in high-density lipoproteins. At the same time, a number of authors did not note such results. Discrepancy in the data is primarily due to the heterogeneity of hypertensive patients, although analysis of the literature suggests that in some hypertensive patients the level of lipids and atherogenic lipoproteins may increase with prolonged treatment with propranolol.



Development of the drug fibronectin and substantiation of its use to stimulate corneal healing
Abstract
The urgency of the search for remedies accelerating corneal healing after its accidental and surgical injuries is obvious. In recent years, along with physical factors, some natural and synthetic substances, fibronectin turned out to be among the most promising therapeutic agents. It is an adhesive protein of connective tissue involved in cell attachment to fibrillar substrates, formation of collagen fibers and intercellular substance. Fibronectin and its fragments have chemotactic activity and can accelerate phagocytosis reactions by macrophages and neutrophils, acting as a non-specific opsonin against many exo- and endogenous pathological microparticles. One form of this protein, called plasma fibronectin, is present in blood and has many biological properties in common with tissue fibronectin.



Current features of diagnosis and treatment of Beck's sarcoidosis
Abstract
Despite the long history of studying sarcoidosis, many questions of etiology and pathogenesis, diagnosis and treatment of this disease have not yet been clarified. In recent years, the incidence of sarcoidosis has increased markedly. According to the data of diagnostic department of the Republican anti-TB Dispensary in 1970-1975 there were registered only 6 cases of sarcoidosis, but in 1976-1980 and 1981-1987 their number increased 6-8 times. An important factor in the inflow of sarcoidosis patients to TB dispensaries is the detection of such persons mainly during prophylactic fluorography. Doctors of various profiles - therapists, phthisiatricians, radiologists, oncologists and other specialists, who in their practical work experience certain difficulties in differential diagnosis, treatment and registration of these patients, have to deal with sarcoidosis patients.



Effect of intraoperative hemodilution on lung and blood respiratory function after abdominal delivery
Abstract
Caesarean section surgery is always accompanied by significant blood loss, the value of which varies quite widely - on average, from 800 to 900 ml. Tactics to compensate blood loss during this operation is constantly debated in the press, and there are completely polar points of view - from the recognition of the need to compensate blood loss "drop by drop" and even create hypervolemia to the complete rejection of transfusion therapy during abdominal delivery.



Expert evaluation of patients' ability to work after cystectomy with bladder replacement by intestinal grafts
Abstract
251 cystectomies for bladder cancer with different methods of urine diversion were performed in the urology clinic. 171 patients underwent urine diversion into an isolated bowel segment with restoration of independent urethral urination. The stage of the cancer process in them was distributed according to the international classification as follows: T2 - in 37 patients, T3 - in 121, T4 - in 13 patients.



Experience of intracavernous silicone prosthesis implantation for erectile impotence
Abstract
At present time surgical treatment of erectile impotence is gaining more and more supporters.
40 surgical aids for persistent erectile dysfunction were performed at the urological department of the Republican Clinical Hospital of the TASSR Ministry of Health Care in 1985-1987. Prostheses were implanted in both cavernous bodies in 30 patients and in one body in 10 patients. The indications for surgical treatment were complete absence of adequate and spontaneous erections during three years of unsuccessful treatment by a sexopathologist, absence of auditory and visual stimulation, partial regression of libido.



Energy-frequency electroencephalogram parameters of diabetic patients depending on morphotype
Abstract
In diabetic patients the physique is characterized by android distribution of subcutaneous fat, i.e. excess in the neck, chin, back, abdomen and decrease in the extremities. Obviously, the characteristic morphotype is a particular manifestation of the general constitution.






Analysis of craniocerebral injuries in Bugulma district for 1976-1986
Abstract
In the area with a population of 106,000 people in 1976-1986, there was an upward trend in the frequency of craniocerebral injuries. The ratio of the number of men and women with craniocerebral injuries by years was as follows: men - 55-58%, women - 42-45%. The frequency of cranial and brain injuries increases in men at the age of 30-50 years, and in women at the age of 50 years.



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.



On birth injuries of the upper cervical vertebrae
Abstract
The examination of 2000 children of the first two years of life revealed 160 children with neurological signs of moderately pronounced lesions of the upper spinal cord. We radiographed the upper cervical vertebrae through the open mouth. 72 children were at the age of the first 3 months of life, 62 were under 6 months, 18 were under one year, and 8 were older than one year. Eight of these children were born prematurely and 25 were born with a body weight of more than 4 kg. Sixteen of the 160 infants were born breech. The obstetric history of 160 children was not so complicated: obstetric aids were required only for 8 newborns. Fifty-six of the 160 children were born in white asphyxia and 41 in blue asphyxia. Consequently, secondary asphyxia was very frequent, and given the unexpected number of radiological and clinical findings we found, this asphyxia can also be interpreted as a consequence of birth trauma in an apparently normal delivery. In addition, we noticed that 47 mothers of our patients had a rapid pushing period, which is given great importance as a traumatic factor.



Middle ear cancer developed against the background of chronic purulent otitis media
Abstract
Despite significant advances in the treatment of cancer patients in recent years, the diagnosis and treatment of malignant neoplasms of the middle ear remain very difficult. In part, this can be explained by the difficulty of recognizing cancer in its early stages and by the late seeking of medical help by patients.
We consider it possible to present our own observation.



A case of hereditary angioedema
Abstract
Allergic edema is one of the most common clinical manifestations of hypersensitivity reactions. The characteristic clinic, a clear association with a specific allergen, the data of allergological examination of such patients usually leave no doubt about the diagnosis. However, such forms of edema occur, which resemble Quincke's edema, but have other mechanisms of development unrelated to allergy, in particular hereditary angioedema categorized by A. D. Ado into a group of pseudoallergic reactions. Despite its relative rarity, this disease has a very malignant course and, if not diagnosed and treated in time, can lead to an adverse outcome.



In vivo diagnosis of pericardial mesothelioma
Abstract
According to the literature, primary pericardial tumors are extremely rare, rarer than cardiac tumors. By 1980, 117 reports on this pathology had been published in the world literature, most of which were based on autopsy data. Difficulties of in vivo diagnosis of pericardial mesothelioma are due to the absence of pathognomonic symptoms. The presence of hemorrhagic effusion in the absence of isoinflammatory manifestations and the results of cytological study of the exudate allow suspecting the tumor.
Here is our observation.






Peculiarities of functional state of pituitary-adrenal system in patients with hypertension
Abstract
We studied functional state of adenohypophyseal-adrenal system in hypertensive patients. 127 patients with hypertension of I and II stages according to WHO classification (59 men and 68 women) aged 17-60 years (mean age 48,7 years) were investigated. Patients with Stage I hypertension (Group I) had systolic and diastolic BP of 22.6±1.1 and 13.0±0.6 kPa, respectively (mean duration of disease: 4 years). Arterial hypertension in stage II patients (group 2) was stable, 25.4±1.3 and 14.7±1.1 kPa (mean duration of illness - 11 years). The control group included 32 healthy individuals.



Changes in nervous system function in women with subclinical forms of late gestosis of pregnant women
Abstract
We determined the functional state of the sympathetic-adrenal system (SAD) and electroencephalography data in women with subclinical forms of late gestosis in pregnant women.
32 women aged 20 to 35 years at 20 to 26 weeks' gestation underwent comprehensive examination. Twenty of them were first-pregnant and 12 were second-pregnant. Depending on the predicted form of late gestosis, the pregnant women were divided into two groups.



Pre-disease as a stage of the adjustment process
Abstract
"Define the meaning of words, and you will free mankind from half of its worries. This aphorism by René Descartes comes to mind involuntarily when one gets acquainted with the theses of the XVIII All-Union Congress of Physicians "Pre-disease - Disease - Recovery" [5]. The concept of "pre-disease" is interpreted in different ways! There are "risk factors" and "hereditary conditioned enzymopathies", "preconditions" and "precursors" of disease development, "initial disturbances of functions" and simply "functional disturbances as a precursor of a disease", "incubation period" (of non-infectious diseases), "incipient (of noninfectious diseases! - S.V.) and "prodromes of a disease", "premorbid condition" and "preclinical stages", "disease pre-diseases" (diseases preceding the development of a disease! - S.V.) and, alas, much more and much more. All this, undoubtedly, is the result of the lack of a unified definition of the concept of "pre-disease", that is, its generally recognized content and distinctive features.



The posture of young schoolchildren and its impact on the functional state of some body systems
Abstract
In many cases, the factor determining the development of scoliosis in childhood can be a violation of posture. The present work is devoted to the study of the posture of young schoolchildren in learning activities - the study of changes in the functional state of the cardiovascular, muscular systems, posture in statics and in dynamics under the influence of the formation of its correct skills.



Republican conference "Topical issues of organization of outpatient and polyclinic care".
Abstract
The conference was held within the framework of the implementation of the target comprehensive program "Health" for strengthening the prevention of diseases and strengthening the health of the population of the Tatar ASSR for 1986-1990. It focused on the issues of continuous improvement of labor conditions, sanitary and health measures, prevention of general and professional morbidity, traumatism, creation of good living and rest conditions for people. The conference was attended by the management of the TASSR Ministry of Health and the Republican Clinical Hospital, professors and lecturers of universities in Kazan, heads of Party and Soviet bodies of Bavly district, responsible employees of medical equipment department, pharmacy department, chief physicians of hospitals, polyclinics and their deputies.



Academician of the USSR Academy of Medical Sciences, Professor Andrey Dmitriyevich Ado
Abstract
The name of A.D. Ado, Academician of the USSR Academy of Medical Sciences, laureate of the State Prize of the USSR, as the greatest pathophysiologist and allergologist is well known to the medical community not only in our country, but also abroad. He is an honorable member of several foreign academies and scientific societies (GDR, Czechoslovakia, Spain, FRG), member of editorial boards of several European scientific journals and for more than 25 years he has been a WHO expert.



Professor Gilya Fazilovna Sultanova
Abstract
December 1988 marked the 60th anniversary of her birthday and 38 years of her medical, scientific, pedagogical and social activities as the Head of Children's Diseases Department of Ulyanov Chuvash State University, Doctor of Medical Sciences, Professor Gili Fazilovna Sultanova.



Associate Professor Irshat Zakirovich Mukhutdinov
Abstract
In February 1989, it will be 60 years since his birth and 36 years of work of Irshat Zakirovich Mukhutdinov, head of the educational and scientific-production association KSRIEM-KGMI, director of KSRIEM, head of the epidemiology department of Kazan Medical Institute named after S.V. Kurashov, associate professor, RSFSR honored doctor.



Chronicle. Vol. 70, No. 1 (1989)
Abstract
On September 16-17, 1988 in Chelyabinsk the IX Plenum of the Board of the All-Russian Scientific Society of Physicians on the problems: "Gerontology in the Clinic of Internal Diseases" and "Dispensary Treatment of Workers and Employees of Industrial Enterprises and Rural Residents".


