Vol 70, No 1 (1989)

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.

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.

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 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

We observed several patients with arrhythmic shock in whom a favorable therapeutic effect was obtained using HeNe laser radiation in the complex therapy of arrhythmic shock. We present the following two observations.

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.

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.

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.

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.